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General NPI Number Information
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NPI Number | 1306196209
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Entity Type | Organization
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Legal Business Name | CEDARS HEALTH
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 428 S DURBIN ST
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City | CASPER
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State | WY
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Zip | 82601-2818
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Country | US
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Telephone | 307-277-3867
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Fax |
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Provider Business Mailing Address
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Address Line | 428 S DURBIN ST SUITE 201
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City | CASPER
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State | WY
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Zip | 82601-2818
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Country | US
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Telephone | 307-277-3867
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. MICHEL SKAF
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Credential | MD
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Telephone | 307-277-3867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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