Provider Demographics
NPI:1831294081
Name:COLLEGE HILL HEALTH CENTER
Entity Type:Organization
Organization Name:COLLEGE HILL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MALINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-253-4103
Mailing Address - Street 1:3000 COLLEGE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-4202
Mailing Address - Country:US
Mailing Address - Phone:801-253-4103
Mailing Address - Fax:801-931-2044
Practice Address - Street 1:3000 COLLEGE DR
Practice Address - Street 2:SUITE A
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4202
Practice Address - Country:US
Practice Address - Phone:801-253-4103
Practice Address - Fax:801-931-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY110763100Medicaid
WY307009Medicare ID - Type Unspecified
WYCE9032Medicare PIN