Healthcare Provider Details

I. General information

NPI: 1871660159
Provider Name (Legal Business Name): CROOK COUNTY MEDICAL SERVICES DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/20/2022
Certification Date: 09/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 OAK STREET
SUNDANCE WY
82729-0517
US

IV. Provider business mailing address

713 OAK STREET PO BOX 517
SUNDANCE WY
82729-0517
US

V. Phone/Fax

Practice location:
  • Phone: 307-283-3501
  • Fax: 307-283-2255
Mailing address:
  • Phone: 307-283-3501
  • Fax: 307-283-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number07-127
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MICKI DAHNE LYONS
Title or Position: CEO
Credential: DNP
Phone: 307-283-3501