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Contact Information

POWELL VALLEY HEALTH CARE, INC.
777 AVENUE H
POWELL, WY82435-2260
 Phone: 307-754-1125
 Fax: 307-754-1176
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for POWELL VALLEY HEALTH CARE, INC.

NPI Number 1104965003
LBN Legal business name POWELL VALLEY HEALTH CARE, INC.
Authorized official TERRY ODOM - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2007
Last updated 03/07/2023 - About 3 years ago
Identifiers
WY License # 5201342
WY Medicaid 107049500
WY Medicaid 107049502
WY Medicaid 107185807
WY Other 007203 BCBS PROVIDER #
WY Other 5201342 NCPDP
WY Other 5201342 PART D AETNA PROVIDER #
WY Other 520134 PART D CAREMARXK PROVIDER
WY Other 5201342 PART D RX SOLUTIONS PROV
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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