Organization
PHS INDIAN HEALTH SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA ROBINSON (CREDENTIALING COORDINATOR)
(307) 335-5964
Entity
Organization
Contact information
Practice address
29 BLACK COAL DRIVE, FORT WASHAKIE, WY 82514-0128
(307) 332-7300
(307) 332-5753
Mailing address
PO BOX 128, FORT WASHAKIE, WY 82514-0128
(307) 332-7300
(307) 332-5753
Taxonomy
Speciality
Code
Description
License number
State
261QP0904X
Federal Public Health Clinic/Center
Primary
19751
WY
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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