Provider Demographics
NPI:1568426435
Name:MEMORIAL HOSPITAL OF LARAMIE COUNTY
Entity Type:Organization
Organization Name:MEMORIAL HOSPITAL OF LARAMIE COUNTY
Other - Org Name:CHEYENNE REGIONAL MEDICAL CENTER HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF BILLING SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:E
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-773-8237
Mailing Address - Street 1:214 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3748
Mailing Address - Country:US
Mailing Address - Phone:307-634-2273
Mailing Address - Fax:
Practice Address - Street 1:2600 E 18TH ST
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5511
Practice Address - Country:US
Practice Address - Phone:307-633-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEMORIAL HOSPITAL OF LARAMIE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-17
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY07-218251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107334603Medicaid
WY107334616Medicaid
WY107334601Medicaid
WY537014Medicare Oscar/Certification