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NPI Code Detail

MEDICARE: TETON COUNTY HOSPITAL DISTRICT

MEDICARE: TETON COUNTY 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
1251G00000XCommunity Based Hospice Care Agency15121WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568493989
Entity Type Code : Organization
Provider Name (Legal Business Name) : TETON COUNTY HOSPITAL DISTRICT
Provider Business Mailing Address
First Line : PO BOX 428
Second Line :
City : JACKSON
State : WY
Zip : 83001-0428
Country : US
Telephone Number : 307-739-4853
Fax Number : 307-414-4729
Provider Business Practice Location Address
First Line : 625 E BROADWAY AVE
Second Line :
City : JACKSON
State : WY
Zip : 83001-8642
Country : US
Telephone Number : 307-739-6135
Fax Number : 307-414-4729
Authorized Official
Title or Position : COO/CFO
Name : JOHN JOSEPH KREN
Credential :
Telephone Number : 307-739-7526
Provider Enumeration Date : 07/05/2006
Last Update Date : 06/18/2022

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Directions to “TETON COUNTY HOSPITAL DISTRICT ” Practice Location

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