| High Desert Healthcare | |
|
1013 East Boxelder Rd Suite 200 Gillette WY 82718 | |
| (307) 257-7620 | |
| (307) 257-7618 |
| Full Name | High Desert Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 1013 East Boxelder Rd, Gillette, Wyoming |
| Authorized Official Name and Position | Alicia Mae Lepard (OWNER) |
| Authorized Official Contact | 3072577620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| High Desert Healthcare 1013 East Boxelder Rd Suite 200 Gillette WY 82718 Ph: (307) 257-7620 | High Desert Healthcare 1013 East Boxelder Rd Suite 200 Gillette WY 82718 Ph: (307) 257-7620 |
| NPI Number | 1750726212 |
|---|---|
| Provider Enumeration Date | 05/09/2013 |
| Last Update Date | 10/11/2018 |
| Medicare PECOS PAC ID | 7618103433 |
|---|---|
| Medicare Enrollment ID | O20131126000345 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750726212 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Wyoming) | Primary |
| Provider Name | Alicia Le Pard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346470770 PECOS PAC ID: 7012194855 Enrollment ID: I20110606000053 |
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