Organization
SOUTH LINCOLN HOSPITAL DISTRICT
Active
Other names
SOUTH LINCIOLN MEDICAL CLINIC, South Lincoln Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RYERSE (CEO)
(307) 800-8650
Entity
Organization
Contact information
Practice address
711 ONYX ST, KEMMERER, WY 83101
(307) 877-4401
(307) 877-3236
Mailing address
711 ONYX ST, KEMMERER, WY 83101-3214
(307) 877-4401
(307) 877-3236
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
06-148
WY
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00943001
BLUE CROSS
WY
05
—
106769901
—
WY
01
—
830267172002
WORKER'S COMP
WY
01
—
830267172A001
CHAMPUS
WY
Enumeration date
11/14/2006
Last updated
10/24/2025
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