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General NPI Number Information
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NPI Number | 1578824801
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Entity Type | Organization
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Legal Business Name | CHEYENNE REGIONAL URGENT CARE, LLC
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 433 E 19TH ST
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City | CHEYENNE
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State | WY
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Zip | 82001-4643
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Country | US
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Telephone | 307-773-8133
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 912491
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City | DENVER
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State | CO
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Zip | 80291-2491
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Country | US
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Telephone | 307-773-8133
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | KERRY WARBURTON
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Credential |
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Telephone | 307-633-7937
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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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