Provider Demographics
NPI:1013057173
Name:CASTLE ROCK SPECIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:CASTLE ROCK SPECIAL HOSPITAL DISTRICT
Other - Org Name:WY BREAST AND CERVICAL EARLY DETECTION PROGRAM
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BYBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-872-4530
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-0219
Mailing Address - Country:US
Mailing Address - Phone:307-872-4500
Mailing Address - Fax:307-872-4595
Practice Address - Street 1:1400 UINTA DR
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-5046
Practice Address - Country:US
Practice Address - Phone:307-872-4500
Practice Address - Fax:307-872-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty