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Organization

STATE OF WYOMING

Active
Other names
WYOMING STATE TRAINING SCHOOL
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN KULOW (OPERATIONS MGR)
(307) 335-6762
Entity
Organization

Contact information

Practice address
8204 STATE HIGHWAY 789, LANDER, WY 82520-2941
(307) 335-6719
(307) 335-6987
Mailing address
8204 STATE HIGHWAY 789, LANDER, WY 82520-2941
(307) 335-6719
(307) 335-6987

Taxonomy

Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
5202926IP
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100180900
WY
05
100180901
WY
01
2111516
PK
Enumeration date
01/30/2007
Last updated
12/31/2013
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