WYOMING MEDICATION DONATION PROGRAM
Mail Order Pharmacy
Cheyenne, Wyoming
Provider NPI: 1154661320
Organization Information:Organization Name: WYOMING MEDICATION DONATION PROGRAM
Practice Location:
2508 E FOX FARM RD STE 2A CHEYENNE, WY 82007 US
Tel: 307-635-1297 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2508 E FOX FARM RD STE 2A CHEYENNE, WY 82007 US
Tel: 307-635-1297 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 333600000X | Suppliers Pharmacy | ||
N | 3336M0002X | Suppliers Pharmacy | ||
Y | 3336C0003X | Suppliers Pharmacy | WY | R10065 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 5204487 | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin