Provider Demographics
NPI:1679712384
Name:WYOMING HOME HEALTH INC.
Entity Type:Organization
Organization Name:WYOMING HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-655-1883
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:MOORCROFT
Mailing Address - State:WY
Mailing Address - Zip Code:82721-0189
Mailing Address - Country:US
Mailing Address - Phone:307-756-3344
Mailing Address - Fax:307-756-3394
Practice Address - Street 1:116 N LITTLE HORN AVE
Practice Address - Street 2:
Practice Address - City:MOORCROFT
Practice Address - State:WY
Practice Address - Zip Code:82721-5045
Practice Address - Country:US
Practice Address - Phone:307-756-3344
Practice Address - Fax:307-756-3394
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WYOMING HOME HEALTH INC. DBA SHARONS HOME HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-19
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY132943001Medicaid
WY114074401Medicaid