Healthcare Provider Details

I. General information

NPI: 1073720322
Provider Name (Legal Business Name): THAYNE EMTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 S MAIN ST
THAYNE WY
83127-1607
US

IV. Provider business mailing address

PO BOX 942
THAYNE WY
83127-0942
US

V. Phone/Fax

Practice location:
  • Phone: 307-883-4383
  • Fax: 307-883-4382
Mailing address:
  • Phone: 307-883-4383
  • Fax: 307-883-4382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: ADAM HANSEN
Title or Position: CAPTAIN
Credential:
Phone: 307-883-4383