| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 E. Whalen St., Guernsey, Wyoming |
| Authorized Official Name and Position | Zachary Miller (CEO) |
| Authorized Official Contact | 3075347054 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | 1 E. Whalen St. Guernsey WY 82214 Ph: (307) 322-3861 |
| NPI Number | 1376084160 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 08/26/2024 |
| Medicare PECOS PAC ID | 6709798150 |
|---|---|
| Medicare Enrollment ID | O20170609001750 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376084160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Platte County Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 E Whalen St, Guernsey, WY 82214 Phone: 307-322-3861 | |
Banner Health Physicians West Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 E Whalen Street, Guernsey, WY 82214 Phone: 307-322-3861 Fax: 307-322-2018 | |