NPIMap

Organization Active NPI

Weston County Hospital District

Doing business as Weston County Pharmacy

  • Community/Retail Pharmacy
  • Newcastle, WY
National Provider Identifier
1649660671
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
R10140 Issued in WY
Legal business name
WESTON COUNTY HOSPITAL DISTRICT
Doing business as
Weston County Pharmacy
Practice address
1124 Washington Blvd
Newcastle, WY 82701-2972
Phone
(307) 746-2425
Fax
(307) 746-9263
NPI assigned
Jan 29, 2015
Last updated
Nov 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tavis Weidenbach
Title
Director of Pharmacy/Ao
Phone
(307) 746-3742

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X R10140 WY Primary

Addresses

Primary practice location

1124 Washington Blvd
Newcastle, WY 82701-2972

Mailing address

727A Washington Blvd
Newcastle, WY 82701-2930
Phone (307) 746-2425

Other identifiers 1

IdentifierTypeStateIssuer
2149854OtherPK

Other names 1

  • Weston County Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151029000373 WY DME Supplier - Pharmacy 0042293276 Practice locations: Newcastle, WY
O20200506003375 WY Part B Supplier - Mass Immunization (Roster Biller Only) 0042293276 Practice locations: Newcastle, WY

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Upton Pharmacy7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Weston County Health ServicesNewcastle, WY, CCN 531303 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 1998
Weston County Health ServicesNewcastle, WY, CCN 53Z303 Hospital 5% Or Greater Direct Ownership Interest (100%) May 5, 1998
Weston County Hospital DistrictNewcastle, WY, CCN 535023 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Weston County Health ServicesNewcastle, WY, CCN 537050 Home health agency Operational/Managerial Control Sep 1, 2007
Weston County Health ServicesUpton, WY, CCN 533807 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 1, 2021
Jan 1, 2021
Weston County Hospital DistrictNewcastle, WY, CCN 533806 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) May 5, 1998

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1649660671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727A WASHINGTON BLVD",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012930",
            "telephone_number": "307-746-2425",
            "fax_number": "307-746-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 WASHINGTON BLVD",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012972",
            "telephone_number": "307-746-2425",
            "fax_number": "307-746-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTON COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "WEIDENBACH",
        "authorized_official_first_name": "TAVIS",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY/AO",
        "authorized_official_telephone_number": "307-746-3742"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WY",
            "license": "R10140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149854",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weston County Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newcastle, WY

Sources for this page

Verify at the official NPI Registry.