Provider Demographics
NPI:1821472903
Name:COWBOY CARES, INC.
Entity Type:Organization
Organization Name:COWBOY CARES, INC.
Other - Org Name:COWBOY CARES HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD OF DIRECTORS/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-786-4357
Mailing Address - Street 1:PO BOX 1449
Mailing Address - Street 2:
Mailing Address - City:LYMAN
Mailing Address - State:WY
Mailing Address - Zip Code:82937
Mailing Address - Country:US
Mailing Address - Phone:307-786-4357
Mailing Address - Fax:307-459-1020
Practice Address - Street 1:70 MEADOW STREET
Practice Address - Street 2:
Practice Address - City:LYMAN
Practice Address - State:WY
Practice Address - Zip Code:82937
Practice Address - Country:US
Practice Address - Phone:307-786-4357
Practice Address - Fax:307-459-1020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 251G00000X
WY15233251E00000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY156524Medicaid