Organization
WIND RIVER FAMILY & COMMUNITY HEALTH CARE
Active
Parent organization
WIND RIVER FAMILY & COMMUNITY HEALTH CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
WIND RIVER FAMILY & COMMUNITY HEALTH CARE
Authorized official
KERRIE MINICK (BUSINESS ADMINISTRATOR)
(307) 856-9281
Entity
Organization
Contact information
Practice address
511 N 12TH ST E, RIVERTON, WY 82501-3809
(307) 463-4488
Mailing address
PO BOX 1310, RIVERTON, WY 82501-0158
(307) 856-9281
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP0904X
Federal Public Health Clinic/Center
Primary
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Enumeration date
03/19/2019
Last updated
11/06/2024
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