Evanston Hospital Corporation

NPI #1255304051 in Evanston, Wyoming

Provider Information

NPI Number
1255304051
Entity Type
Organization
Organization Name
Evanston Hospital Corporation
Subpart
Yes (part of a larger organization)
Parent Organization
EVANSTON HOSPITAL CORPORATION
Primary Specialty
Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
Enumeration Date
Feb 10, 2006
Last Updated
Sep 3, 2020

Practice Location

Address
112 YELLOW CREEK RD
State
Wyoming
ZIP Code
82930-9266
Phone
(307) 789-3636

Authorized Official

Name
RANDY MICHAEL COOPER
Title
SVP FINANCE OPERATIONS/AO
Phone
(615) 221-3840

Specialties & Taxonomy Codes

Specialty
Clinic/Center - End-Stage Renal Disease (ESRD) TreatmentEnd-Stage Renal Disease (ESRD) Treatment

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