Provider Demographics
NPI:1407447766
Name:HOT SPRINGS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:HOT SPRINGS COUNTY HOSPITAL DISTRICT
Other - Org Name:HOT SPRINGS HEALTH - SHOSHONI CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-864-5019
Mailing Address - Street 1:120 N C AVE
Mailing Address - Street 2:
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443-2410
Mailing Address - Country:US
Mailing Address - Phone:307-864-5534
Mailing Address - Fax:307-864-5226
Practice Address - Street 1:702 E 2ND ST
Practice Address - Street 2:
Practice Address - City:SHOSHONI
Practice Address - State:WY
Practice Address - Zip Code:82649
Practice Address - Country:US
Practice Address - Phone:307-876-0221
Practice Address - Fax:307-876-0931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-29
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty