| Organization Name: | EASTERN WYOMING AMBULANCE SERVICE, INC. |
| NPI Number: | 1619974615 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WADE WELLS (PRESIDENT) |
| Mailing Address: | 2450 W Mariposa Pkwy Wheatland |
| State: | WY US |
| Postal Code: | 822013112 |
| Phone Number: | 3073225424 |
| Fax Number: | |
| NPI Enumeration Date: | 07/05/2005 |
| NPI Last Update Date: | 12/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 127 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |