| Snowy Range Health Center | |
|
100 S 6th St Laramie WY 82070-3239 | |
| (307) 460-9888 | |
| (307) 460-9892 |
| Full Name | Snowy Range Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 S 6th St, Laramie, Wyoming |
| Authorized Official Name and Position | Wendy B King (OWNER) |
| Authorized Official Contact | 3077212880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Snowy Range Health Center Po Box 1126 Laramie WY 82073-1126 Ph: (307) 460-9888 | Snowy Range Health Center 100 S 6th St Laramie WY 82070-3239 Ph: (307) 460-9888 |
| NPI Number | 1831580240 |
|---|---|
| Provider Enumeration Date | 02/07/2015 |
| Last Update Date | 01/22/2021 |
| Medicare PECOS PAC ID | 8123337011 |
|---|---|
| Medicare Enrollment ID | O20151015000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831580240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Wendy Burleigh King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235210451 PECOS PAC ID: 2163417965 Enrollment ID: I20101206000993 |
| Provider Name | Peggy Joyce Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073753026 PECOS PAC ID: 7416237979 Enrollment ID: I20161129002676 |
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