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General NPI Number Information
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NPI Number | 1487756102
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Entity Type | Organization
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Legal Business Name | MEDICINE BOW RURAL HEALTH CARE DISTRICT
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 514 IDAHO DR
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City | MEDICINE BOW
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State | WY
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Zip | 82329-0037
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Country | US
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Telephone | 307-379-2222
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Fax | 307-379-2223
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Provider Business Mailing Address
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Address Line | PO BOX 37 514 IDAHO DR
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City | MEDICINE BOW
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State | WY
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Zip | 82329-0037
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Country | US
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Telephone | 307-379-2222
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Fax | 307-379-2223
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Authorized Official
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Title or Position | MA/CPT/EMT
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Name | ADAM BARRON
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Credential |
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Telephone | 307-379-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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