Provider Demographics
NPI:1124254271
Name:SOUTH CENTRAL WYOMING EMS JOINT
Entity type:Organization
Organization Name:SOUTH CENTRAL WYOMING EMS JOINT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSBEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-710-7559
Mailing Address - Street 1:PO BOX 1192
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:WY
Mailing Address - Zip Code:82331-1192
Mailing Address - Country:US
Mailing Address - Phone:307-710-7559
Mailing Address - Fax:307-326-5052
Practice Address - Street 1:1402 SOUTH RIVER ST
Practice Address - Street 2:#1192
Practice Address - City:SARATOGA
Practice Address - State:WY
Practice Address - Zip Code:82331-1192
Practice Address - Country:US
Practice Address - Phone:307-326-5052
Practice Address - Fax:307-326-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1433416L0300X
WY1423416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW22849Medicare PIN