Ppm Wyoming Llc | |
770 S Washington St Ste B Afton WY 83110-5135 | |
(888) 253-6598 | |
Not Available |
Full Name | Ppm Wyoming Llc |
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Speciality | Clinic/Center |
Location | 770 S Washington St Ste B, Afton, Wyoming |
Authorized Official Name and Position | Amber Tueller (CORPORATE SECRETARY) |
Authorized Official Contact | 2084011400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Ppm Wyoming Llc 1916 N 700 W Ste 110 Layton UT 84041-5754 Ph: (385) 427-1570 | Ppm Wyoming Llc 770 S Washington St Ste B Afton WY 83110-5135 Ph: (888) 253-6598 |
NPI Number | 1366289290 |
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Provider Enumeration Date | 07/09/2024 |
Last Update Date | 07/09/2024 |
Medicare PECOS PAC ID | 9032659768 |
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Medicare Enrollment ID | O20240910000000 |
Identifier | Type | State | Issuer |
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1366289290 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Tim R Schuijt |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801550553 PECOS PAC ID: 7113312620 Enrollment ID: I20241004002392 |
High Country Behavioral Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 389 Adams Street, Afton, WY 83110 Phone: 307-885-9883 Fax: 307-885-5206 | |
Sterling Provider Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 47 Doc Perkes Rd, Afton, WY 83110 Phone: 307-885-3637 Fax: 307-885-3638 |