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NPI Code Detail

MEDICARE: CEDAR HILLS FAMILY CLINIC, P.C.

MEDICARE: CEDAR HILLS FAMILY CLINIC, P.C.
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
1261QR1300XRural Health Clinic/Center
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1700900719
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEDAR HILLS FAMILY CLINIC, P.C.
Provider Business Mailing Address
First Line : 1121 WASHINGTON BLVD
Second Line :
City : NEWCASTLE
State : WY
Zip : 82701-2968
Country : US
Telephone Number : 307-746-3582
Fax Number : 307-746-9744
Provider Business Practice Location Address
First Line : 1121 WASHINGTON BLVD
Second Line :
City : NEWCASTLE
State : WY
Zip : 82701-2968
Country : US
Telephone Number : 307-746-3582
Fax Number : 307-746-9744
Authorized Official
Title or Position : PRESIDENT
Name : DR. LANNY B REIMER
Credential : M.D.
Telephone Number : 307-746-3582
Provider Enumeration Date : 03/16/2007
Last Update Date : 04/29/2010

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