Provider Demographics
NPI:1194839001
Name:WYOMING HOME HEALTH INC
Entity Type:Organization
Organization Name:WYOMING HOME HEALTH INC
Other - Org Name:SHARONS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:DOV
Authorized Official - Middle Name:
Authorized Official - Last Name:ORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-838-0053
Mailing Address - Street 1:950 S CHERRY ST STE 716
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2665
Mailing Address - Country:US
Mailing Address - Phone:347-838-0053
Mailing Address - Fax:
Practice Address - Street 1:1103 E BOXELDER RD STE JB
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-5557
Practice Address - Country:US
Practice Address - Phone:307-257-2896
Practice Address - Fax:307-370-5702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY114074400Medicaid
WY114074401Medicaid