Organization
MEMORIAL HOSPITAL OF LARAMIE COUNTY
Active
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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