Organization
WYOMING MEDICATION DONATION PROGRAM
Active
Organization
WYOMING MEDICATION DONATION PROGRAM
Active
Other names
Wyoming Medication Donation Program
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA GALLIZZI (PHARM.D., PIC, PROGRAM MANAGER)
(307) 635-1297
Entity
Organization
Contact information
Practice address
2508 E FOX FARM RD STE 2A, CHEYENNE, WY 82007-2559
(307) 635-1297
(307) 635-2156
Mailing address
2300 CAPITOL AVE STE B-27, CHEYENNE, WY 82001-3672
(307) 635-1297
(307) 635-2156
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
R10065
WY
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5204487
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/25/2013
Last updated
04/12/2019
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