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General NPI Number Information
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NPI Number | 1013227016
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Entity Type | Organization
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Legal Business Name | ST. VINCENT HEALTHCARE
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Dates
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Enumeration Date | 10/12/2010
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | 1025 9TH ST
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City | CODY
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State | WY
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Zip | 82414-3441
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Country | US
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Telephone | 877-587-2955
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 9TH ST
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City | CODY
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State | WY
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Zip | 82414-3441
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Country | US
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Telephone | 877-587-2955
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JASON L. BARKER
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Credential |
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Telephone | 406-237-3070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 12129
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License Number State | MT
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