# PAIN CARE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PAIN CARE CENTER LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891390118
- **Legal business name:** PAIN CARE CENTER LLC
- **Authorized official:** RANDAL CHET RUGER (MANAGING PARTNER)
- **Authorized official phone:** (307) 267-2116

## Contact information

- **Practice address:** 945 W BROADWAY AVE APT 202, JACKSON, WY 83001-8217
- **Practice address phone:** (307) 212-6270
- **Practice address fax:** (307) 212-6271
- **Mailing address:** 2620 COMMERCIAL WAY STE 20, ROCK SPRINGS, WY 82901-4705
- **Mailing address phone:** (307) 212-6270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/03/2020
- **Last updated:** 12/03/2020