Wyoming State Hospital

NPI #1104811256 in Evanston, Wyoming

Provider Information

NPI Number: 1104811256
Entity Type: Organization
Organization Name: Wyoming State Hospital
Primary Specialty: Chronic Disease Hospital
Enumeration Date: Sep 14, 2005
Last Updated: Aug 22, 2020

Practice Location

Address: 831 HIGHWAY 150 S
Address 2: PHARMACY RM 519
City: Evanston
State: Wyoming
ZIP Code: 82930-5340
Phone: (307) 789-3464

Authorized Official

Name: MR. PABLO HERNANDEZ, M.D
Title: SUPERINTENDENT
Phone: (307) 789-3464

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chronic Disease Hospital	281P00000X	Primary

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