Provider Demographics
NPI:1619963956
Name:HOT SPRINGS COUNTY MEMORIAL HOSPITAL HOME CARE SERVICES
Entity Type:Organization
Organization Name:HOT SPRINGS COUNTY MEMORIAL HOSPITAL HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-864-3121
Mailing Address - Street 1:150 E ARAPAHOE ST
Mailing Address - Street 2:ATTN: HOME CARE SERVICES
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443-2402
Mailing Address - Country:US
Mailing Address - Phone:307-864-5585
Mailing Address - Fax:307-864-5471
Practice Address - Street 1:150 E ARAPAHOE ST
Practice Address - Street 2:ATTN: HOME CARE SERVICES
Practice Address - City:THERMOPOLIS
Practice Address - State:WY
Practice Address - Zip Code:82443-2402
Practice Address - Country:US
Practice Address - Phone:307-864-5585
Practice Address - Fax:307-864-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY06190251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY537052Medicare ID - Type Unspecified