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General NPI Number Information
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NPI Number | 1265547350
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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 | 08/20/2006
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 300 S BURMA AVE
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City | GILLETTE
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State | WY
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Zip | 82716
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Country | US
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Telephone | 307-688-6230
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Fax | 307-688-6210
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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 | 307-688-1551
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRES; INTERIM CEO
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Name | ANDREW FITZGERALD
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 07-093
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License Number State | WY
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