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General NPI Number Information
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NPI Number | 1124254271
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Entity Type | Organization
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Legal Business Name | SOUTH CENTRAL WYOMING EMS JOINT
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 1402 SOUTH RIVER ST #1192
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City | SARATOGA
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State | WY
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Zip | 82331-1192
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Country | US
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Telephone | 307-326-5052
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Fax | 307-326-5052
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Provider Business Mailing Address
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Address Line | PO BOX 1192
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City | SARATOGA
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State | WY
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Zip | 82331-1192
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Country | US
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Telephone | 307-710-7559
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Fax | 307-326-5052
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Authorized Official
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Title or Position | DIRECTOR
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Name | STAYTON MOSBEY
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Credential |
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Telephone | 307-710-7559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 143
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 142
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License Number State | WY
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