Organization
SOUTH LINCOLN HOSPITAL DISTRICT
Active
Other names
South Lincoln Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID RYERSE (CEO/ADMINISTRATOR)
(307) 800-8650
Entity
Organization
Contact information
Practice address
711 ONYX ST, KEMMERER, WY 83101-3214
(307) 877-4401
(307) 877-3236
Mailing address
711 ONYX ST, KEMMERER, WY 83101-3214
(307) 877-4401
(307) 877-3236
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
282NC0060X
Critical Access Hospital
Primary
09-133
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007401
BLUE CROSS
WY
01
—
00918001
BLUE SHIELD
WY
05
—
105993900
—
WY
05
—
105993902
—
WY
05
—
105993904
—
WY
01
—
185636600
FEDERAL WORKER'S COMPENSATION
—
01
—
320145
BLACK LUNG
WY
01
—
5442
UNION PACIFIC RAILROAD
—
01
—
831010000
TRICARE
—
Enumeration date
03/03/2009
Last updated
10/28/2025
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