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General NPI Number Information
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NPI Number | 1043443575
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Entity Type | Organization
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Legal Business Name | BIG HORN ENTERPRISES, INC
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 641 WARREN ST
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City | THERMOPOLIS
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State | WY
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Zip | 82443
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Country | US
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Telephone | 307-864-2153
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Fax |
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Provider Business Mailing Address
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Address Line | 641 WARREN ST
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City | THERMOPOLIS
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State | WY
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Zip | 82443
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Country | US
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Telephone | 307-864-2153
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Fax |
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Authorized Official
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Title or Position | FINANICAL MANAGER
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Name | MR. GENE WANNER
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Credential |
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Telephone | 307-864-2153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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