Provider Demographics
NPI:1629399902
Name:SWEETWATER COUNTY DISTRICT BOARD OF HEALTH
Entity Type:Organization
Organization Name:SWEETWATER COUNTY DISTRICT BOARD OF HEALTH
Other - Org Name:SWEETWATER COUNTY COMMUNITY NURSING SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM COUNTY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GERKEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-922-5390
Mailing Address - Street 1:731 C ST STE 315
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-6231
Mailing Address - Country:US
Mailing Address - Phone:307-922-5390
Mailing Address - Fax:307-922-5496
Practice Address - Street 1:731 C ST
Practice Address - Street 2:SUITE 315
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-6202
Practice Address - Country:US
Practice Address - Phone:307-922-5390
Practice Address - Fax:307-922-5496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY10289251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health