Provider Demographics
NPI:1134364888
Name:SOUTH BIG HORN COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:SOUTH BIG HORN COUNTY HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TADD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-568-3311
Mailing Address - Street 1:388 US HIGHWAY 20 S
Mailing Address - Street 2:
Mailing Address - City:BASIN
Mailing Address - State:WY
Mailing Address - Zip Code:82410-8902
Mailing Address - Country:US
Mailing Address - Phone:307-568-3311
Mailing Address - Fax:307-568-2139
Practice Address - Street 1:388 US HIGHWAY 20 S
Practice Address - Street 2:
Practice Address - City:BASIN
Practice Address - State:WY
Practice Address - Zip Code:82410-8902
Practice Address - Country:US
Practice Address - Phone:307-568-3311
Practice Address - Fax:307-568-2139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTH BIG HORN COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-10
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY53Z301Medicare PIN