Provider Demographics
NPI:1225081649
Name:CAMPBELL COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:CAMPBELL COUNTY HOSPITAL DISTRICT
Other - Org Name:WRIGHT CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN RECRUITER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-688-1554
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:WRIGHT
Mailing Address - State:WY
Mailing Address - Zip Code:82732-0100
Mailing Address - Country:US
Mailing Address - Phone:307-464-0413
Mailing Address - Fax:307-464-1526
Practice Address - Street 1:500 LATIGO DRIVE
Practice Address - Street 2:
Practice Address - City:WRIGHT
Practice Address - State:WY
Practice Address - Zip Code:82732-0100
Practice Address - Country:US
Practice Address - Phone:307-464-0413
Practice Address - Fax:307-464-1526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY106337500Medicaid
WYW4371982Medicare PIN