Organization
WYOMING MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REDEEM D SUMICAD (PRESIDENT)
(307) 413-2087
Entity
Organization
Contact information
Practice address
220 E BROADWAY, JACKSON, WY 83001
(307) 413-2087
(877) 382-7638
Mailing address
3060 S BRIDLE DR, JACKSON, WY 83001-9124
(307) 413-2087
(877) 382-7638
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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