COWBOY MEDICAL GROUP PC; NPI #1154836617

Contact Information

COWBOY MEDICAL GROUP PC

1125 CHARLES AVE
WORLAND, WY 82401-4021

Phone: 307-347-2449
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rural Health	261QR1300X	B4[14]	Rural Health Clinic
Family Medicine	207Q00000X	08	Physician/Family Practice

Indicates primary specialty

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NPI Profile & details for COWBOY MEDICAL GROUP PC

NPI #	`1154836617`
LBN Legal business name	COWBOY MEDICAL GROUP PC
Authorized official	WADE BOMENGEN - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	12/06/2017
Last updated	01/19/2018 - About 8 years ago
Identifiers	n/a

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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