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General NPI Number Information
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NPI Number | 1972743011
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Entity Type | Organization
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Legal Business Name | SOUTH LINCOLN HOSPITAL DISTRICT
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 711 ONYX ST
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City | KEMMERER
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State | WY
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Zip | 83101-3214
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Country | US
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Telephone | 307-877-4401
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Fax | 307-877-3236
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Provider Business Mailing Address
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Address Line | 711 ONYX ST
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City | KEMMERER
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State | WY
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Zip | 83101-3214
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Country | US
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Telephone | 307-877-4401
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Fax | 307-877-3236
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MR. DAVID RYERSE
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Credential |
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Telephone | 307-800-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 09-133
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License Number State | WY
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