MEDICARE: INTERMOUNTAIN HOME COMPANIONS D/B/A INTERMOUNTAIN HOME HEALTH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	253Z00000X	In Home Supportive Care Agency
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1619514346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERMOUNTAIN HOME COMPANIONS D/B/A INTERMOUNTAIN HOME HEALTH

Provider Business Mailing Address
First Line	:	P.O. BOX 1648
Second Line	:
City	:	MILLS
State	:	WY
Zip	:	82644
Country	:	US
Telephone Number	:	307-337-2772
Fax Number	:	307-337-2773

Provider Business Practice Location Address
First Line	:	800 WERNER CT STE 125
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-1323
Country	:	US
Telephone Number	:	307-337-2772
Fax Number	:	307-337-2773

Authorized Official
Title or Position	:	OWNER,CEO,AGENCY
Name	:	MS. RACHAEL ANN BICKELS
Credential	:	MSN,RN
Telephone Number	:	307-267-0501

Provider Enumeration Date	:	12/02/2019
Last Update Date	:	06/16/2023

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