Coram Healthcare of Wyoming, LLC

NPI #1720035249 in Cheyenne, Wyoming

Provider Information

NPI Number
1720035249
Entity Type
Organization
Organization Name
Coram Healthcare of Wyoming, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
CORAM HEALTHCARE OF WYOMING, LLC
Primary Specialty
Clinic/Center - Infusion Therapy
Enumeration Date
May 29, 2006
Last Updated
Oct 8, 2007

Practice Location

Address
1507 STILLWATER AVE
Address 2
SUITE C
State
Wyoming
ZIP Code
82009-7358
Phone
(307) 635-3785

Authorized Official

Name
VITO PONZIO, JR
Title
SR VP
Phone
(303) 672-8631

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Infusion TherapyInfusion Therapy

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