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General NPI Number Information
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NPI Number | 1639191562
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Entity Type | Organization
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Legal Business Name | COUNTY OF GOSHEN
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 2025 CAMPBELL DR #1
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City | TORRINGTON
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State | WY
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Zip | 82240-1548
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Country | US
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Telephone | 307-532-4069
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Fax | 307-532-4060
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Provider Business Mailing Address
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Address Line | 2025 CAMPBELL DR #1
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City | TORRINGTON
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State | WY
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Zip | 82240-1548
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Country | US
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Telephone | 307-532-4069
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Fax | 307-532-4060
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Authorized Official
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Title or Position | COUNTY NURSE MANAGER
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Name | HEATHER M DITTMER
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Credential | BSN, RN
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Telephone | 307-532-4069
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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 | 07-162
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 07-162
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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