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General NPI Number Information
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NPI Number | 1073976155
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Entity Type | Organization
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Legal Business Name | CAMPBELL COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1405 W 4TH ST
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City | GILLETTE
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State | WY
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Zip | 82716-3327
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Country | US
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Telephone | 307-688-4368
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Fax | 307-688-7935
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Provider Business Mailing Address
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Address Line | PO BOX 3011
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City | GILLETTE
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State | WY
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Zip | 82717-3011
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Country | US
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Telephone | 307-688-1000
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Fax | 307-685-3079
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Authorized Official
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Title or Position | CEO
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Name | MATT SHAHAN
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Credential |
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Telephone | 307-688-1551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A922
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License Number State | WY
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