NPIMap

Organization Active NPI

South Lincoln Hospital District

Doing business as South Lincoln Medical Center

  • Institutional Pharmacy
  • Kemmerer, WY
National Provider Identifier
1700910411
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
52-03675-IP Issued in WY
Legal business name
SOUTH LINCOLN HOSPITAL DISTRICT
Doing business as
South Lincoln Medical Center
Practice address
711 Onyx St
Kemmerer, WY 83101-3214
Phone
(307) 877-4401
Fax
(307) 877-3236
NPI assigned
Mar 15, 2007
Last updated
Jan 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Authorized official

Name
Mr. Eric H Boley
Title
Ceo
Phone
(307) 877-4401

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 52-03675-IP WY Primary
Long Term Care Pharmacy 3336L0003X 52-03675 WY

Addresses

Primary practice location

711 Onyx St
Kemmerer, WY 83101-3214

Mailing address

711 Onyx St
Kemmerer, WY 83101-3214
Phone (307) 877-4401

Other identifiers 1

IdentifierTypeStateIssuer
105993909MedicaidWY

Other names 1

  • South Lincoln Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325721600000",
    "number": "1700910411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 ONYX ST",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831013214",
            "telephone_number": "307-877-4401",
            "fax_number": "307-877-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 ONYX ST",
            "city": "KEMMERER",
            "state": "WY",
            "postal_code": "831013214",
            "telephone_number": "307-877-4401",
            "fax_number": "307-877-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LINCOLN HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2012-01-05",
        "status": "A",
        "authorized_official_last_name": "BOLEY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "307-877-4401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "WY",
            "license": "52-03675-IP",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WY",
            "license": "52-03675",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105993909",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Lincoln Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kemmerer, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.