| Organization Name: | CARE UNITED MEDICAL CENTER OF LARAMIE, LLC |
| NPI Number: | 1063720605 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL SURDAM (OWNER) |
| Mailing Address: | 3810 E. Grand Ave Laramie |
| State: | WY US |
| Postal Code: | 82070 |
| Phone Number: | 3077211794 |
| Fax Number: | 3077211795 |
| NPI Enumeration Date: | 09/16/2010 |
| NPI Last Update Date: | 04/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |