MEDICARE: URGENT CARE OF CASPER, 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
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1932396199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	URGENT CARE OF CASPER, LLC

Provider Business Mailing Address
First Line	:	2546 E 2ND ST
Second Line	:	#200
City	:	CASPER
State	:	WY
Zip	:	82609-2062
Country	:	US
Telephone Number	:	307-265-1110
Fax Number	:	307-265-1108

Provider Business Practice Location Address
First Line	:	2546 E 2ND ST
Second Line	:	#200
City	:	CASPER
State	:	WY
Zip	:	82609-2062
Country	:	US
Telephone Number	:	307-265-1110
Fax Number	:	307-265-1108

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	MRS. KATHY WATSON
Credential	:
Telephone Number	:	307-265-1110

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	07/29/2013

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