Provider Demographics
NPI:1912266008
Name:NORTH BIG HORN HOSPITAL PHARMACY
Entity Type:Organization
Organization Name:NORTH BIG HORN HOSPITAL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-548-5203
Mailing Address - Street 1:1115 LANE 12
Mailing Address - Street 2:
Mailing Address - City:LOVELL
Mailing Address - State:WY
Mailing Address - Zip Code:82431
Mailing Address - Country:US
Mailing Address - Phone:307-548-5200
Mailing Address - Fax:307-548-5205
Practice Address - Street 1:1115 LANE 12
Practice Address - Street 2:
Practice Address - City:LOVELL
Practice Address - State:WY
Practice Address - Zip Code:82431
Practice Address - Country:US
Practice Address - Phone:307-548-5200
Practice Address - Fax:307-548-5205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY52-00176-IP282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural