Provider Demographics
NPI:1164621777
Name:NORTH BIG HORN HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:NORTH BIG HORN HOSPITAL DISTRICT
Other - Org Name:NBH URGENT CARE CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:W
Authorized Official - Last Name:BIRKHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-548-5203
Mailing Address - Street 1:1115 LANE 12
Mailing Address - Street 2:
Mailing Address - City:LOVELL
Mailing Address - State:WY
Mailing Address - Zip Code:82431-9537
Mailing Address - Country:US
Mailing Address - Phone:307-548-5200
Mailing Address - Fax:307-548-5205
Practice Address - Street 1:1115 LANE 12
Practice Address - Street 2:
Practice Address - City:LOVELL
Practice Address - State:WY
Practice Address - Zip Code:82431-9537
Practice Address - Country:US
Practice Address - Phone:307-548-5200
Practice Address - Fax:307-548-5205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY08-171261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care