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General NPI Number Information
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NPI Number | 1457462087
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Entity Type | Organization
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Legal Business Name | COUNTY OF FREMONT
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 1052 PETERSDORF DR
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City | RIVERTON
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State | WY
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Zip | 82501-2308
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Country | US
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Telephone | 307-857-3669
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Fax | 307-857-3665
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Provider Business Mailing Address
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Address Line | 1052 PETERSDORF DR
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City | RIVERTON
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State | WY
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Zip | 82501-2308
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Country | US
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Telephone | 307-857-3669
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Fax | 307-857-3665
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LAURI A WEMPEN
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Credential |
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Telephone | 307-857-3669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 125
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License Number State | WY
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