Provider Demographics
NPI:1447512959
Name:CAMPBELL COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:CAMPBELL COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PATIENT FINANCIAL SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-688-1492
Mailing Address - Street 1:508 STOCKTRAIL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3582
Mailing Address - Country:US
Mailing Address - Phone:307-686-1413
Mailing Address - Fax:307-682-1113
Practice Address - Street 1:508 STOCKTRAIL AVE STE A
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3582
Practice Address - Country:US
Practice Address - Phone:307-686-1413
Practice Address - Fax:307-682-1113
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMPBELL COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-11
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty