MEDICARE: NORTH BIG HORN HOSPITAL DISTRICT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	07-200	WY

General Provider Information

NPI Number	:	1396742219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH BIG HORN HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	598 W 900 S STE 220
Second Line	:
City	:	WOODS CROSS
State	:	UT
Zip	:	84010-8195
Country	:	US
Telephone Number	:	801-397-4697
Fax Number	:	801-296-9117

Provider Business Practice Location Address
First Line	:	475 YELLOW CREEK ROAD
Second Line	:
City	:	EVANSTON
State	:	WY
Zip	:	82930-5109
Country	:	US
Telephone Number	:	307-789-0726
Fax Number	:	307-789-1438

Authorized Official
Title or Position	:	CEO
Name	:	ERIC SHUMWAY CONNELL
Credential	:
Telephone Number	:	307-548-5203

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	11/06/2025

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