Healthcare Provider Details
I. General information
NPI: 1609103407
Provider Name (Legal Business Name): BIG HORN URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/16/2009
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
813 HIGHLAND AVE
SHERIDAN WY
82801
US
IV. Provider business mailing address
813 HIGHLAND AVE
SHERIDAN WY
82801
US
V. Phone/Fax
- Phone: 307-673-5501
- Fax: 307-673-5434
- Phone: 307-673-5501
- Fax: 307-673-5434
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHEL
SKAF
Title or Position: PRESIDENT AND CEO
Credential: M.D.
Phone: 307-277-3867