POWELL VALLEY HEALTH CARE, INC. (NPI# 1104965003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104965003 |
| Entity Type | Organization |
| Organization Name | POWELL VALLEY HEALTH CARE, INC. |
| Practice Address |
777 Avenue H Powell WY 82435-2260 |
| Practice Telephone | 3077541125 |
| Practice Fax Number | 3077541176 |
| Mailing Telephone | 3077541125 |
| Mailing Fax Number | 3077541176 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-05-07 |
| Authorized Official Name | MS. TERRY ODOM (CEO) |
| Authorized Official Telephone | 3077541125 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
5201342 | WY | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
5201342 | WY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | PART D CAREMARXK PROVIDER | 520134 | 01 |
| WY | 107049500 | 05 | |
| WY | 107049502 | 05 | |
| WY | PART D RX SOLUTIONS PROV | 5201342 | 01 |
| WY | PART D AETNA PROVIDER # | 5201342 | 01 |
| WY | 107185807 | 05 | |
| WY | BCBS PROVIDER # | 007203 | 01 |
| WY | DEA | BP3284471 | 01 |
| WY | NCPDP | 5201342 | 01 |
| Street Address |
777 AVENUE H |
| City | POWELL |
| State | WY |
| Zip Code | 82435-2260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114923463 | Duncan Hugh Fraser | Podiatrist | 777 Avenue H, Powell, WY 82435-2260 | 2005-06-22 |
| 1639782790 | Nicolle Rae Cruz | Pharmacist | 777 Avenue H, Powell, WY 82435-2260 | 2020-08-28 |
| 1043843485 | Jessica Lee Mathews | Emergency Medical Technician, Paramedic | 777 Avenue H, Powell, WY 82435-2260 | 2020-02-13 |
| 1073150926 | Mary Neal | Dietitian, Registered | 777 Avenue H, Powell, WY 82435-2260 | 2019-12-10 |
| 1609418334 | Randall Keith Baxter | Nurse Practitioner | 777 Avenue H, Powell, WY 82435-2260 | 2019-10-15 |
| 1508329582 | Ashley Dee Engesser | Advanced Practice Midwife | 777 Avenue H, Powell, WY 82435-2260 | 2019-04-08 |
| 1780149948 | Bryan Kenneth Tipton | Physician Assistant | 777 Avenue H, Powell, WY 82435-2260 | 2019-02-01 |
| 1811460397 | Katherine Lindsey Swope | Speech-Language Pathologist | 777 Avenue H, Powell, WY 82435-2260 | 2019-01-07 |
| 1629571963 | Big Horn Ankle & Foot LLC | Durable Medical Equipment & Medical Supplies | 777 Avenue H, Powell, WY 82435-2260 | 2018-03-13 |
| 1538687652 | Amanda Bisby | Nurse Practitioner | 777 Avenue H, Powell, WY 82435-2260 | 2017-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841762648 | Cynthia Jean Garhart | Counselor | 235 East 2nd Street, Powell, WY 82435 | 2018-12-19 |
| 1982114138 | Peggy Ruth Cheatham | Case Manager/Care Coordinator | 317 S Day St, Powell, WY 82435 | 2017-10-02 |
| 1669921532 | Heavens Peak Behavioral Health Services, Ins | Clinic/Center | 64 Safe Haven Rd, Powell, WY 82435 | 2016-10-03 |
| 1730636895 | Kara Baus | Registered Nurse | 112 Safe Haven Road, Powell, WY 82435 | 2016-09-07 |
| 1942620208 | Susan C Hawkinson | Speech-Language Pathologist | 558 E 2nd St., Children's Resource Center Attention: Ila Jean Jenkins, Powell, WY 82435 | 2014-04-24 |
| 1376963801 | Shelby Marie Frost | Nurse Practitioner | 246 N Absaroka St, Powell, WY 82435 | 2014-04-23 |
| 1578993549 | Doni Lauk | Case Management | 458 S Ferris St, Powell, WY 82435 | 2013-11-12 |
| 1144579731 | Move On Physical Therapy, Inc. | Physical Therapist | 1201 E. 7th Street, Powell, WY 82435 | 2012-08-29 |
| 1992008841 | Justin Dean Mccoll | Counselor | 89 Rd 8 Ra, Powell, WY 82435 | 2010-12-15 |
| 1588977250 | James Lloyd | Obstetrics & Gynecology | 777 Ave H., Powell Valley Healthcare, Powell, WY 82435 | 2010-07-22 |
| Find all providers in zip 82435 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598395659 | Debbie Smith Turski | Pharmacy | 7565 Dannaher Dr, Powell, TN 37849-4029 | 2020-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023154564 | State of Wyoming | Pharmacy | 8204 State Highway 789, Lander, WY 82520-2941 | 2007-01-30 |
| 1518050947 | Weston County Hospital District | Pharmacy | 1124 Washington Blvd, Newcastle, WY 82701-2972 | 2006-09-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.