Provider Demographics
NPI:1174524607
Name:HOT SPRINGS COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:HOT SPRINGS COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-864-5065
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:156 N 6TH STREET
Mailing Address - City:BASIN
Mailing Address - State:WY
Mailing Address - Zip Code:82410-0388
Mailing Address - Country:US
Mailing Address - Phone:307-568-2499
Mailing Address - Fax:307-568-2699
Practice Address - Street 1:156 N. 6TH STREET
Practice Address - Street 2:
Practice Address - City:BASIN
Practice Address - State:WY
Practice Address - Zip Code:82410-0388
Practice Address - Country:US
Practice Address - Phone:307-568-2499
Practice Address - Fax:307-568-2699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY5946A207Q00000X
WY207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107327310Medicaid
WY107327310Medicaid
WY307354Medicare PIN