Organization
WIND RIVER FAMILY & COMMUNITY HEALTH CARE
Active
Parent organization
WIND RIVER FAMILY & COMMUNITY HEALTH CARE
Other names
Wind River Cares - Ethete
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
707 BLUE SKY HIGHWAY, ETHETE, WY 82520
(307) 855-2751
(307) 335-1038
Mailing address
PO BOX 1310, RIVERTON, WY 82501-0158
(307) 856-9281
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154097100
—
WY
Enumeration date
03/22/2019
Last updated
11/06/2024
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