| Cowboy Clinic And Urgent Care Llc | |
|
2001 Main St Torrington WY 82240-2708 | |
| (307) 462-1054 | |
| Not Available |
| Full Name | Cowboy Clinic And Urgent Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2001 Main St, Torrington, Wyoming |
| Authorized Official Name and Position | Sarah Jacobson (CEO) |
| Authorized Official Contact | 3074621054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cowboy Clinic And Urgent Care Llc 2001 Main St Torrington WY 82240-2708 Ph: () - | Cowboy Clinic And Urgent Care Llc 2001 Main St Torrington WY 82240-2708 Ph: (307) 462-1054 |
| NPI Number | 1750892436 |
|---|---|
| Provider Enumeration Date | 10/20/2017 |
| Last Update Date | 10/26/2018 |
| Medicare PECOS PAC ID | 1456691013 |
|---|---|
| Medicare Enrollment ID | O20190318001161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750892436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Primary |
| Provider Name | Matthew Jacobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003360991 PECOS PAC ID: 0446548150 Enrollment ID: I20190403001207 |
| Provider Name | Beth Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750934139 PECOS PAC ID: 0648603738 Enrollment ID: I20191203002413 |
| Provider Name | Amy L Johansson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205412590 PECOS PAC ID: 9638558091 Enrollment ID: I20220615002858 |
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