MEDICARE: CEDARS HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261Q00000X	Clinic/Center
2	261QU0200X	Urgent Care Clinic/Center
3	261QX0100X	Occupational Medicine Clinic/Center
4	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1134630247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEDARS HEALTH

Provider Business Mailing Address
First Line	:	428 S DURBIN ST STE 104
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2818
Country	:	US
Telephone Number	:	307-337-4284
Fax Number	:

Provider Business Practice Location Address
First Line	:	1453 DEWAR DR UNIT A
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-5821
Country	:	US
Telephone Number	:	307-382-2466
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHEL W SKAF
Credential	:
Telephone Number	:	307-337-4284

Provider Enumeration Date	:	10/16/2017
Last Update Date	:	10/16/2017

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Directions to “CEDARS HEALTH ” Practice Location

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