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Organization

CITY OF PINE BLUFFS

Active
Other names
Pine Bluffs-EMS
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON R WELLER (DIRECTOR)
(307) 245-3400
Entity
Organization

Contact information

Practice address
220 MAIN STREET, PINE BLUFFS, WY 82082-0429
(307) 245-3746
Mailing address
PO BOX 641880, OMAHA, NE 68164-7880
(402) 572-4019
(402) 965-8594

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
63
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114308500
WY
01
306502
BLUE CROSS BLUE SHIELD
WY
Enumeration date
01/16/2007
Last updated
01/11/2011
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