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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