MEDICARE: SWEETWATER COUNTY COMMUNITY NURSING SERVICE

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	251E00000X	Home Health Agency	06-071	WY
2	251B00000X	Case Management Agency	06-071	WY
3	251K00000X	Public Health or Welfare Agency	06-071	WY
4	251C00000X	Developmentally Disabled Services Day Training Agency	07-008	WY

General Provider Information

NPI Number	:	1922077858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWEETWATER COUNTY COMMUNITY NURSING SERVICE

Provider Business Mailing Address
First Line	:	731 C ST
Second Line	:	SUITE 315
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-6202
Country	:	US
Telephone Number	:	307-352-6830
Fax Number	:	307-352-6844

Provider Business Practice Location Address
First Line	:	731 C ST
Second Line	:	SUITE 315
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-6202
Country	:	US
Telephone Number	:	307-352-6830
Fax Number	:	307-352-6844

Authorized Official
Title or Position	:	NURSING MANAGER
Name	:	JODYE WILMES
Credential	:	RN
Telephone Number	:	307-352-6830

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	09/11/2025

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