RED ROCK FAMILY PRACTICE, INC; NPI #1316914922

Contact Information

RED ROCK FAMILY PRACTICE, INC

120 N C AVE
THERMOPOLIS, WY 82443-2410

Phone: 307-864-5534
Fax: 307-864-9470
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for RED ROCK FAMILY PRACTICE, INC

NPI Number 1316914922

LBN Legal business name RED ROCK FAMILY PRACTICE, INC

Authorized official WADE BOMENGEN - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/02/2006

Last updated 12/29/2017 - About 8 years ago

Identifiers

Medicaid

116973401

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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