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General NPI Number Information
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NPI Number | 1629399902
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Entity Type | Organization
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Legal Business Name | SWEETWATER COUNTY DISTRICT BOARD OF HEALTH
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 731 C ST SUITE 315
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-6202
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Country | US
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Telephone | 307-922-5390
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Fax | 307-922-5496
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Provider Business Mailing Address
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Address Line | 731 C ST STE 315
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-6231
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Country | US
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Telephone | 307-922-5390
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Fax | 307-922-5496
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Authorized Official
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Title or Position | INTERIM COUNTY MANAGER
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Name | JANET LYNN GERKEN
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Credential | R.N.
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Telephone | 307-922-5390
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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 | 10289
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License Number State | WY
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