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Shoshone Tribe
End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Fort Washakie, Wyoming
NPI 1790824530

Shoshone Tribe is a End-Stage Renal Disease (ESRD) Treatment Clinic/Center based in Fort Washakie, WY and is specialized in End-Stage Renal Disease (ESRD) Treatment. Shoshone Tribe practices in Fort Washakie, WY. The NPI Number for Shoshone Tribe is 1790824530 and holds a License No. 07-177 (Wyoming).

The current practice location address for Shoshone Tribe is 11 Shipton Lane, Fort Washakie, WY and can be reached out via phone at 307-332-2998 and via fax at 307-332-4955.

Location: 11 Shipton Lane, Fort Washakie, WY, 82514-0998
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1790824530
Provider Name
Shoshone Tribe
Credential
Provider Entity Type
Organization
Address
11 Shipton Lane, Fort Washakie, WY, 82514-0998
Phone Number
307-332-2998
Fax Number
307-332-4955
Provider Enumeration Date
02/06/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
11 Shipton Lane
City
Fort Washakie
State
Wyoming
Zip
82514
Phone Number
307-332-2998
Fax Number
307-332-4955
person
Provider Business Mailing Address Details
Address
11 Shipton Lane
City
Fort Washakie
State
Wyoming
Zip
82514
Phone Number
307-332-2998
Fax Number
307-332-4955
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
End-Stage Renal Disease (ESRD) Treatment
Taxonomy
261QE0700X
License No.
07-177 (Wyoming)
Definition
Definition to come...
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