National Provider Identifier Database

TETON COUNTY HOSPITAL DISTRICT
Hospice Care, Community Based


Contact Information

TETON COUNTY HOSPITAL DISTRICT
555 E BROADWAY AVE
SUITE #115
JACKSON, WY83001-8640
Phone: 307-739-7465
Fax: 307-739-7645
Website:
Specialty Taxonomy Code
* Hospice Care, Community Based 251G00000X

* Indicates primary specialty

NPI Profile & details for TETON COUNTY HOSPITAL DISTRICT

NPI Number 1568493989
Legal business name
LBN
TETON COUNTY HOSPITAL DISTRICT
Authorized official MITCHELL WATSON - (CFO)
Entity Organization
Organization subpart Yes
Enumeration date 07/05/2006
Last updated 02/02/2026 - About 4 months ago
Sole proprietor1 Not specified
Identifiers
  • WY License #: 15121
  • WY Medicaid: 106299916

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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