NPI 1104811256

Wyoming State Hospital

Organisation Chronic Disease Hospital Evanston, WY

Practice location

Address: 831 Highway 150 S Pharmacy Rm 519, Evanston, WY 82930-5340
Phone: (307) 789-3464
Fax: (307) 789-3660
Mailing address: 831 Highway 150 S PO Box 177, Evanston, WY 82930-5340

Authorised official

Name: Pablo Hernandez
Title: Superintendent
Phone: (307) 789-3464

Registered specialties

Chronic Disease Hospital Primary

Hospitals Taxonomy 281P00000X Licence 52-01138 (WY)

Other Chronic Disease Hospital providers in Wyoming →

Registry record

NPI: 1104811256
Entity type: Organization
NPI issued: 14 Sep 2005
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.