Provider Demographics
NPI:1346927118
Name:SUBLETTE COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:SUBLETTE COUNTY HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-367-4757
Mailing Address - Street 1:PO BOX 627
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:WY
Mailing Address - Zip Code:82941-0627
Mailing Address - Country:US
Mailing Address - Phone:307-367-4133
Mailing Address - Fax:307-367-6636
Practice Address - Street 1:625 E HENNICK ST
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:WY
Practice Address - Zip Code:82941-5228
Practice Address - Country:US
Practice Address - Phone:130-736-7348
Practice Address - Fax:307-367-6636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care