Frontier Wyoming, L.L.C.
Organization Active NPI Home Health Agency · Lander, WY
NPI 1053503565 · NPPES record last updated Oct 28, 2014
Key facts
- NPI
- 1053503565
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 0713203 (WY)
- Legal business name
- FRONTIER WYOMING, L.L.C.
- Practice address
- 230 N 1St St
Lander, WY 82520-2838 - Phone
- (307) 332-2922
- Fax
- (307) 332-0106
- NPI assigned
- Aug 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Martha M Bogucki
- Title
- Cfo
- Phone
- (203) 693-3840
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jun 1, 2021 | Change of Ownership |
Enhabit Home Health |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Home Health Agency | 251E00000X | 0713203 | WY | Yes |
Addresses
Primary practice location
230 N 1St St
Lander, WY 82520-2838
Mailing address
53 River St
Yankee Professional Building
Milford, CT 06460-3346
Phone (203) 693-3840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053503565 | Medicaid | WY |
Other names
- Frontier Home Health and Hospice
Other providers in Lander, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.