=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255421228
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH LINCOLN COUNTY HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2006
-----------------------------------------------------
Last Update Date | 12/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 130 HOSPITAL LANE
-----------------------------------------------------
City | AFTON
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 83110
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-885-5900
-----------------------------------------------------
Fax | 307-885-3802
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 901 ADAMS ST
-----------------------------------------------------
City | AFTON
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 83110-9621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-885-5900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DANIEL ORDYNA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 307-885-5886
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 313M00000X
-----------------------------------------------------
Taxonomy Name | Nursing Facility/Intermediate Care Facility
-----------------------------------------------------
License Number | 06105
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------