| Wamsutter Community Health Center | |
|
401 Fultz Drive Wamsutter WY 82336-0338 | |
| (307) 324-8869 | |
| (307) 324-8969 |
| Full Name | Wamsutter Community Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 401 Fultz Drive, Wamsutter, Wyoming |
| Authorized Official Name and Position | Craig Staker (PRESIDENT -BOARD OF TRUSTEES) |
| Authorized Official Contact | 3073249534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wamsutter Community Health Center Po Box 338 Wamsutter WY 82336-0338 Ph: (307) 324-8869 | Wamsutter Community Health Center 401 Fultz Drive Wamsutter WY 82336-0338 Ph: (307) 324-8869 |
| NPI Number | 1407341308 |
|---|---|
| Provider Enumeration Date | 06/25/2018 |
| Last Update Date | 06/25/2018 |
| Medicare PECOS PAC ID | 6901158716 |
|---|---|
| Medicare Enrollment ID | O20181005001169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407341308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David R Dansie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184889982 PECOS PAC ID: 2062680648 Enrollment ID: I20120829000845 |
| Provider Name | Brytton L Long |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063709905 PECOS PAC ID: 7517190853 Enrollment ID: I20140731001076 |
| Provider Name | Michael William Bowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104112119 PECOS PAC ID: 5799901401 Enrollment ID: I20140731002490 |
| Provider Name | Lawrence Lauridsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386993400 PECOS PAC ID: 3678707916 Enrollment ID: I20160107000060 |
| Provider Name | Jocelyn Lee Palinek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386139236 PECOS PAC ID: 9335487974 Enrollment ID: I20190206002973 |
| Provider Name | Tenny Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790278141 PECOS PAC ID: 3577804954 Enrollment ID: I20190411002650 |
Wamsutter Community Health Center26- Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Fultz Drive, Wamsutter, WY 82336 Phone: 307-328-0468 Fax: 307-324-9438 |