Provider Demographics
NPI:1588879035
Name:COUNTY OF WESTON
Entity type:Organization
Organization Name:COUNTY OF WESTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-746-4775
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WY
Mailing Address - Zip Code:82701-0130
Mailing Address - Country:US
Mailing Address - Phone:307-746-4775
Mailing Address - Fax:307-746-4774
Practice Address - Street 1:400 STAMPEDE ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WY
Practice Address - Zip Code:82701-3037
Practice Address - Country:US
Practice Address - Phone:307-746-4775
Practice Address - Fax:307-746-4774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY107317600Medicaid
WY107317601Medicaid
WY308139Medicare ID - Type Unspecified