National Provider Identifier Database

RED ROCK FAMILY PRACTICE INC
Rural Health


Contact Information

RED ROCK FAMILY PRACTICE, INC
120 N C AVE
THERMOPOLIS, WY82443-2410
Phone: 307-864-5534
Fax: 307-864-9470
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for RED ROCK FAMILY PRACTICE, INC

NPI Number 1316914922
Legal business name
LBN
RED ROCK FAMILY PRACTICE, INC
Authorized official WADE BOMENGEN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 03/02/2006
Last updated 12/29/2017 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • WY Medicaid: 116973401

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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