Organization
CAMPBELL COUNTY MEMORIAL HOSPITAL HOME MEDICAL RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDY FITZGERALD (EXECUTIVE VICE PRESIDENT)
(307) 688-1520
Entity
Organization
Contact information
Practice address
1708 W HIGHWAY 14-16, GILLETTE, WY 82716-3342
(307) 688-6260
(307) 688-6265
Mailing address
1708 W HIGHWAY 14-16, GILLETTE, WY 82716-3342
(307) 688-6260
(307) 688-6265
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
17004748
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312799
PROVIDER NUMBER FOR BCBS
WY
Enumeration date
06/19/2006
Last updated
08/22/2020
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