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General NPI Number Information
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NPI Number | 1720175920
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Entity Type | Organization
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Legal Business Name | BIG HORN DRUG
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Dates
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Enumeration Date | 10/07/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 513 GREYBULL AVE
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City | GREYBULL
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State | WY
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Zip | 82426-2038
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Country | US
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Telephone | 307-765-4601
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Fax | 307-765-4600
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Provider Business Mailing Address
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Address Line | PO BOX 232
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City | GREYBULL
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State | WY
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Zip | 82426-0232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RONALD WENDLING
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Credential |
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Telephone | 307-765-4601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5202661
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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