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WYOMING STATE HOSPITAL NPI 1104811256


NPI Information

NPI: 1104811256
Provider Name: WYOMING STATE HOSPITAL
Classification: Chronic Disease Hospital - 281P00000X
Entity Type: Organization

CLIA Number: 53D0679889

Address:
831 HIGHWAY 150 S
PHARMACY RM 519
EVANSTON, WY
ZIP 82930
Phone: (307) 789-3464
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WYOMING STATE HOSPITAL is a chronic disease hospital in Evanston, WY. The provider is (1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes. WYOMING STATE HOSPITAL NPI is 1104811256. The provider is registered as an organization entity type.

The provider's business location address is:

831 HIGHWAY 150 S
PHARMACY RM 519
EVANSTON, WY
ZIP 82930-340
Phone: (307) 789-3464
Fax: (307) 789-3660

The provider's authorized official is Pablo Hernandez .
The authorized official title is Superintendent and has the following contact phone number (307) 789-3464.

The CLIA number assigned to this NPI record is 53D0679889 - hospital with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/14/2005 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1281P00000XChronic Disease Hospital52-01138WYOMINGYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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