Organization Name: | MEMORIAL HOSPITAL OF CONVERSE COUNTY |
NPI Number: | 1356496491 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CURT DUGGER (CFO) |
Mailing Address: | 111 S 5th St Douglas |
State: | WY US |
Postal Code: | 826332434 |
Phone Number: | 3073582122 |
Fax Number: | 3073589216 |
NPI Enumeration Date: | 01/25/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |