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Contact Information

WIND RIVER FAMILY & COMMUNITY HEALTH CARE
707 BLUE SKY HIGHWAY
ETHETE, WY82520
 Phone: 307-855-2751
 Fax: 307-335-1038
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

332800000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for WIND RIVER FAMILY & COMMUNITY HEALTH CARE

NPI Number 1346700622
LBN Legal business name WIND RIVER FAMILY & COMMUNITY HEALTH CARE
Authorized official KERRIE MINICK - (BUSINESS ADMINISTRATOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 03/22/2019
Last updated 11/06/2024 - More than a year ago
Identifiers
WY Medicaid 154097100
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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