| Wamsutter Community Health Center26- | |
|
401 Fultz Drive Wamsutter WY 82336 | |
| (307) 328-0468 | |
| (307) 324-9438 |
| Full Name | Wamsutter Community Health Center26- |
|---|---|
| Speciality | Physician Assistant - Medical |
| Location | 401 Fultz Drive, Wamsutter, Wyoming |
| Authorized Official Name and Position | Marvin Wayne Couch Ii (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3073246002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wamsutter Community Health Center26- Po Box 208 Wamsutter WY 82336 Ph: (307) 328-0468 | Wamsutter Community Health Center26- 401 Fultz Drive Wamsutter WY 82336 Ph: (307) 328-0468 |
| NPI Number | 1194056127 |
|---|---|
| Provider Enumeration Date | 01/14/2010 |
| Last Update Date | 01/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194056127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 5629A (Wyoming) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 279 (Wyoming) | Primary |
Wamsutter Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 Fultz Drive, Wamsutter, WY 82336 Phone: 307-324-8869 Fax: 307-324-8969 |