Healthcare Provider Details

I. General information

NPI: 1336933134
Provider Name (Legal Business Name): ROCK SPRINGS I.V. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2025
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 2ND ST STE A-1
ROCK SPRINGS WY
82901-6260
US

IV. Provider business mailing address

400 2ND ST STE A-1
ROCK SPRINGS WY
82901-6260
US

V. Phone/Fax

Practice location:
  • Phone: 307-382-3544
  • Fax: 307-382-0987
Mailing address:
  • Phone: 307-382-3544
  • Fax: 307-382-0987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. GARY PEDRI
Title or Position: PHARMACIST IN CHARGE OWNER
Credential: R.PH.
Phone: 307-382-3544