Organization
MEMORIAL HOSPITAL OF LARAMIE COUNTY
Active
Other names
Cheyenne Regional Davis Hospice Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN PETERSEN (PROVIDER ENROLLMENT SPECIALIST)
(307) 432-3664
Entity
Organization
Contact information
Practice address
6000 SYCAMORE, CHEYENNE, WY 82009
(307) 633-7016
Mailing address
214 E 23RD ST, CHEYENNE, WY 82001-3748
(307) 634-2273
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
251G00000X
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107334606
—
WY
05
—
107334607
—
WI
05
—
107334609
—
WY
Enumeration date
04/14/2006
Last updated
03/22/2024
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