Organization
STAR VALLEY MEDICAL
Active
Other names
Star Valley Home Oxygen
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN OLSON-MILLER RN (OWNER)
(307) 883-3445
Entity
Organization
Contact information
Practice address
180 NORTH MAIN ST, THAYNE, WY 83127-9999
(307) 883-3445
(307) 883-3472
Mailing address
PO BOX 4156, BEDFORD, WY 83112-0156
(307) 883-3445
(307) 883-3472
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114866400
—
WY
Enumeration date
07/27/2006
Last updated
05/28/2008
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