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General NPI Number Information
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NPI Number | 1194869115
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Entity Type | Organization
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Legal Business Name | MEMORIAL HOSPITAL OF CARBON COUNTY
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 1008 FELDSPAR COURT
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City | HANNA
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State | WY
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Zip | 82327
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Country | US
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Telephone | 307-325-6596
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Fax | 307-325-6597
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Provider Business Mailing Address
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Address Line | PO BOX 689
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City | HANNA
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State | WY
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Zip | 82327-0689
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Country | US
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Telephone | 307-325-6596
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Fax | 307-325-6597
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Authorized Official
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Title or Position | CFO
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Name | MICHELLE KEPLINGER
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Credential |
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Telephone | 307-324-8347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 2916A
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License Number State | WY
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