Intermountain Health Cody Clinic | |
424 Yellowstone Ave Ste 310 Cody WY 82414-9310 | |
(307) 578-1800 | |
(307) 578-1814 |
Full Name | Intermountain Health Cody Clinic |
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Speciality | Clinic/Center |
Location | 424 Yellowstone Ave Ste 310, Cody, Wyoming |
Authorized Official Name and Position | Jon Mcdaniel (VP OF FINANCE) |
Authorized Official Contact | 3032720231 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Intermountain Health Cody Clinic 424 Yellowstone Ave Ste 310 Cody WY 82414-9310 Ph: (307) 578-1800 | Intermountain Health Cody Clinic 424 Yellowstone Ave Ste 310 Cody WY 82414-9310 Ph: (307) 578-1800 |
NPI Number | 1235170705 |
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Provider Enumeration Date | 06/08/2006 |
Last Update Date | 08/10/2023 |
Medicare PECOS PAC ID | 9638491574 |
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Medicare Enrollment ID | O20220531001884 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235170705 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 13258 (Montana) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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