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Contact Information

PAIN CARE CENTER LLC
945 W BROADWAY AVE APT 202
JACKSON, WY83001-8217
 Phone: 307-212-6270
 Fax: 307-212-6271
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for PAIN CARE CENTER LLC

NPI Number 1891390118
LBN Legal business name PAIN CARE CENTER LLC
Authorized official RANDAL RUGER - (MANAGING PARTNER)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/03/2020
Last updated 12/03/2020 - About 6 years ago
Identifiers
WY Medicaid 132443800
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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