BEAR LAKE COMMUNITY HEALTH CENTER (NPI# 1922514017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922514017 |
| Entity Type | Organization |
| Organization Name | BEAR LAKE COMMUNITY HEALTH CENTER |
| Other Organization Name | ROCK SPRINGS COMMUNITY HEALTH CENTER PHARMACY -RETAIL |
| Practice Address |
2620 Commercial Way Ste 121 Rock Springs WY 82901-4746 |
| Mailing Address |
1515 N 400 E Ste 104 North Logan UT 84341-7595 |
| Practice Telephone | 3072125105 |
| Practice Fax Number | 3072125105 |
| Mailing Telephone | 4357558424 |
| Mailing Fax Number | 4357558436 |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |
| Authorized Official Name | LAVAL B JENSEN (CEO) |
| Authorized Official Telephone | 4357556061 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEAR LAKE COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
R10166 | WY | Suppliers |
| Other Name | Type Code |
|---|---|
| Rock Springs Community Health Center Pharmacy -Retail | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336705755 | Bear Lake Community Health Center | Pharmacy | 517 W 100 N Ste 210, Providence, UT 84332-9826 | 2019-05-10 |
| 1285140376 | Bear Lake Community Health Center | Pharmacy | 75 Yellow Creek Rd Ste 102, Evanston, WY 82930-5205 | 2017-12-27 |
| 1568732501 | Bear Lake Community Health Center | Pharmacy | 75 Yellow Creek Rd # S-102, Evanston, WY 82930-5235 | 2012-01-09 |
| 1083886865 | Bear Lake Community Health Center | Pharmacy | 1515 N 400 E, Suite 104, North Logan, UT 84341-7561 | 2008-04-01 |
| 1689754475 | Bear Lake Community Health Center | Clinic/Center | 325 W. Logan Hwy, Garden City, UT 84028-0328 | 2006-10-16 |
| 1740383884 | Bear Lake Community Health Center | Pharmacy | 325 W Logan Hwy, Garden City, UT 84028 | 2006-09-06 |
| 1063940344 | Bear Lake Community Health Center | Clinic/Center | 2620 Commercial Way, Rock Springs, WY 82901-4671 | 2017-05-31 |
| 1558806125 | Bear Lake Community Health Center | Clinic/Center | 5 W 200 N, Brigham City, UT 84302-2109 | 2017-01-05 |
| 1861949679 | Bear Lake Community Health Center | Pharmacy | 152 S 4th St, Montpelier, ID 83254-1538 | 2016-09-09 |
| 1003264664 | Bear Lake Community Health Center | Clinic/Center | 152 S 4th St, Montpelier, ID 83254-1538 | 2016-05-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEAR LAKE COMMUNITY HEALTH CENTER, INC. | 325 W Logan Hwy, Garden City, UT 84028 |
| Street Address |
2620 COMMERCIAL WAY STE 121 |
| City | ROCK SPRINGS |
| State | WY |
| Zip Code | 82901-4746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568094043 | Carol Mary Iverson | Naturopath | 120 Winston Dr., Ste. 101, Rock Springs, WY 82901 | 2020-02-12 |
| 1366098691 | Nolan Jeffres | Dentist | 1151 Gateway Blvd, Suite 102, Rock Springs, WY 82901 | 2019-08-13 |
| 1588149181 | Ali Pendleton | Case Manager/Care Coordinator | 79 Winston #235, Rock Springs, WY 82901 | 2018-09-28 |
| 1982142014 | Tammy Fausett | Speech-Language Pathologist | 1105 Applewood Drive, Rock Springs, WY 82901 | 2017-02-09 |
| 1649713983 | Lori Lee Cunningham | Case Manager/Care Coordinator | 325 Archers Trl, Rock Springs, WY 82901 | 2016-11-18 |
| 1841664505 | Theresa Morrison | Case Manager/Care Coordinator | 308 Peak Road, Rock Springs, WY 82901 | 2015-11-18 |
| 1811376478 | Aspen Mountain Medical Center LLC | General Acute Care Hospital | 4401 College Ave, Rock Springs, WY 82901 | 2015-05-28 |
| 1487931416 | Stephanie Lee Dupree | Nurse Practitioner | 1204 Hilltop Dr. #107 & #108, Rock Springs, WY 82901 | 2011-11-04 |
| 1114201845 | Cowboy Urgent Care, Inc | General Practice | 1453-a Dewar Drive, Rock Springs, WY 82901 | 2011-09-29 |
| 1649564931 | Guardian Flight Inc | Ambulance | 1208 Hilltop Drive, Suite 203, Rock Springs, WY 82901 | 2011-06-03 |
| Find all providers in zip 82901 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); 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 |
|---|---|---|---|---|
| 1528121183 | M & K Inc | Pharmacy | 1411 Dewar Dr, Rock Springs, WY 82901 | 2006-12-18 |
| 1396267944 | Bear Lake Community Health Center Pharmacy - 340b | Pharmacy | 2620 Commercial Way, Rock Springs, WY 82901-4671 | 2017-07-14 |
| 1891194494 | Sweetwater County Chc, Inc | Pharmacy | 2620 Commercial Way, Rock Springs, WY 82901-4671 | 2014-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306484092 | Compounding Specialists LLC | Pharmacy | 1540 Centennial Ct Unit 100, Casper, WY 82609-7308 | 2019-12-13 |
| 1710535216 | Spamony20 LLC | Pharmacy | 150 E Hart St, Buffalo, WY 82834-1705 | 2019-08-28 |
| 1689136038 | Cvs Pharmacy Inc | Pharmacy | 1708 Dell Range Blvd, Cheyenne, WY 82009-4945 | 2019-04-04 |
| 1902365240 | Worland Pharmacy Inc. | Pharmacy | 1095 Circle Rd, Worland, WY 82401 | 2019-03-17 |
| 1285140376 | Bear Lake Community Health Center | Pharmacy | 75 Yellow Creek Rd Ste 102, Evanston, WY 82930-5205 | 2017-12-27 |
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1487047122 | Glenrock Hsopital District | Pharmacy | 925 West Birch, Glenrock, WY 82637-0786 | 2015-03-05 |
| 1619386901 | Kmart Pharmacy | Pharmacy | 4000 East 2nd, Casper, WY 82609 | 2014-08-12 |
| 1235402132 | Afton Family Pharmacy | Pharmacy | 141 N Washington St, Afton, WY 83110 | 2012-02-23 |
| 1861789646 | Geneva Woods Retail Pharmacy, LLC | Pharmacy | 1522 East A St, Casper, WY 82601-2217 | 2011-06-30 |
| Find all providers with the same taxonomy | ||||
| City | ROCK SPRINGS |
| Zip Code | 82901 |
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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.