| Intermountain Health Cody Clinic | |
|
424 Yellowstone Ave Ste 310 Cody WY 82414-9310 | |
| (307) 578-1800 | |
| (307) 578-1814 |
| Full Name | Intermountain Health Cody Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 424 Yellowstone Ave Ste 310, Cody, Wyoming |
| Authorized Official Name and Position | Jon Mcdaniel (VP OF FINANCE) |
| Authorized Official Contact | 3032720231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Health Cody Clinic 424 Yellowstone Ave Ste 310 Cody WY 82414-9310 Ph: (307) 578-1800 | Intermountain Health Cody Clinic 424 Yellowstone Ave Ste 310 Cody WY 82414-9310 Ph: (307) 578-1800 |
| NPI Number | 1235170705 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 08/10/2023 |
| Medicare PECOS PAC ID | 9638491574 |
|---|---|
| Medicare Enrollment ID | O20220531001884 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235170705 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 13258 (Montana) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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