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NPI Code Detail

MEDICARE: CHEYENNE OPERATIONS LLC

MEDICARE: CHEYENNE OPERATIONS LLC
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
1314000000XSkilled Nursing Facility05-176WY

General Provider Information

NPI Number : 1750321584
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHEYENNE OPERATIONS LLC
Provider Business Mailing Address
First Line : 3001 KEITH ST NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3713
Country : US
Telephone Number : 423-473-5751
Fax Number : 423-339-8342
Provider Business Practice Location Address
First Line : 1330 PRAIRIE AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82009-4842
Country : US
Telephone Number : 307-778-8997
Fax Number : 307-778-2912
Authorized Official
Title or Position : ASSISTANT SECRETARY
Name : CINDY CROSS
Credential :
Telephone Number : 423-473-5867
Provider Enumeration Date : 06/08/2006
Last Update Date : 02/12/2008

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Directions to “CHEYENNE OPERATIONS LLC ” Practice Location

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