Organization
SOUTH LINCOLN HOSPITAL DISTRICT
Active
Other names
Kemmerer Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEN ARCHER RPH (CEO/AO)
(307) 877-4401
Entity
Organization
Contact information
Practice address
613 MOOSE ST, KEMMERER, WY 83101-3519
(307) 800-8880
(307) 800-8881
Mailing address
613 MOOSE ST, KEMMERER, WY 83101-3519
(307) 800-8880
(307) 800-8881
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
R10162
WY
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167554
PK
—
Enumeration date
02/08/2017
Last updated
03/07/2017
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