Provider Demographics
NPI:1689691503
Name:COUNTY OF FREMONT
Entity Type:Organization
Organization Name:COUNTY OF FREMONT
Other - Org Name:FREMONT COUNTY PUBLIC HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE EXECUTIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JO
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HEHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-856-6979
Mailing Address - Street 1:450 N 2ND ST
Mailing Address - Street 2:RM 350
Mailing Address - City:LANDER
Mailing Address - State:WY
Mailing Address - Zip Code:82520-2302
Mailing Address - Country:US
Mailing Address - Phone:307-332-1073
Mailing Address - Fax:307-332-1064
Practice Address - Street 1:450 N 2ND ST
Practice Address - Street 2:RM 350
Practice Address - City:LANDER
Practice Address - State:WY
Practice Address - Zip Code:82520-2302
Practice Address - Country:US
Practice Address - Phone:307-332-1073
Practice Address - Fax:307-332-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY251B00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107247100Medicaid
WY302746Medicare ID - Type UnspecifiedPROVIDER ID