Organization
EVANSTON HOSPITAL CORPORATION
Active
Organization
EVANSTON HOSPITAL CORPORATION
Active
Parent organization
EVANSTON HOSPITAL CORPORATION
Other names
Evanston Regional Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVANSTON HOSPITAL CORPORATION
Authorized official
RANDY MICHAEL COOPER (SVP FINANCE OPERATIONS/AO)
(615) 221-3840
Entity
Organization
Contact information
Practice address
190 ARROWHEAD DR, EVANSTON, WY 82930-9266
(307) 789-3636
(307) 783-8167
Mailing address
PO BOX 6000 FILE 73783, SAN FRANCISCO, CA 94160-0001
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
06-165
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114835406
—
WY
01
—
41376
BCBS
—
Enumeration date
02/02/2006
Last updated
09/03/2020
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