Cowboy Medical Group PC
Clinic/Center, Rural Health in Worland, WY. Organization (NPI-2).
NPI number1154836617
StatusActive
Last updated in NPPESJan 19, 2018
Details
- NPI
- 1154836617
- Entity type
- Organization (NPI-2)
- Legal business name
- Cowboy Medical Group PC
- Organization subpart
- No
- Enumeration date
- Dec 6, 2017
- Last updated
- Jan 19, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
| 207Q00000X | Family Medicine | – | – |
Practice location
1125 Charles AveWorland, WY 82401-4021
Phone 307-347-2449
Mailing address
1125 Charles AveWorland, WY 82401-4021
Phone 307-347-2449
Authorized official
Wade T Bomengen
Owner
3073472449
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Rural Health Clinic/Center providers in Worland, WY
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.