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General NPI Number Information
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NPI Number | 1255368593
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Entity Type | Organization
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Legal Business Name | WASHAKIE MEDICAL CENTER
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 400 S 15TH ST
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City | WORLAND
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State | WY
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Zip | 82401-3531
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Country | US
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Telephone | 307-347-3221
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 N CENTRAL AVE STE 160
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City | PHOENIX
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State | AZ
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Zip | 85012-2702
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LISA VAN BRUNT
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Credential |
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Telephone | 307-347-3221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 06196
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License Number State | WY
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