Pain Care Center LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PAIN CARE CENTER LLC

Practice address

2620 Commercial Way Ste 20
Rock Springs, WY 82901-4705

Phone

(307) 212-6270

NPI assigned

Dec 9, 2020

Organization subpart

No

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

Authorized official

Name

Randal Chet Ruger

Title

Managing Partner

Phone

(307) 448-2118

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pain Care Centers Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1770189326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 COMMERCIAL WAY STE 20",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014705",
            "telephone_number": "307-212-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 COMMERCIAL WAY STE 20",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829014705",
            "telephone_number": "307-212-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "RUGER",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "CHET",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "307-448-2118"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6838910001",
            "state": "WY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.advancedmd.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2620 Commercial Way Ste 20",
            "city": "Rock Springs",
            "state": "WY",
            "country_code": "US",
            "postal_code": "829014705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Pain Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Optique 20 20, Inc
• Optique 20/20, Inc Rock Springs
• Oral & Maxillofacial Surgeons of Wyoming
• Brittany Nicole Owens
• Mariah Pacheco, FNP
• Pain Care Center, LLC
• Kendra Pandalis
• Elizabeth Parker
• Nancy Parker, SLP
• Domieka Parks

• Durable Medical Equipment & Medical Supplies in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Durable Medical Equipment & Medical Supplies in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.