Organization
NIOBRARA COUNTY HOSPITAL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICHOLAS RYAN DOUCETTE (CHIEF EXECUTIVE OFFICER)
(307) 334-4000
Entity
Organization
Contact information
Practice address
921 S BALLANCEE AVENUE, LUSK, WY 82225
(307) 334-4000
(307) 334-2712
Mailing address
PO BOX 780, LUSK, WY 82225-0780
(307) 334-4000
(307) 334-0183
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
06-203
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1217348
—
WY
01
—
41778
BLUE CROSS BLUE SHIELD
WY
Enumeration date
06/14/2006
Last updated
02/08/2021
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