TETON COUNTY HOSPITAL DISTRICT (NPI# 1972657179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972657179 |
| Entity Type | Organization |
| Organization Name | TETON COUNTY HOSPITAL DISTRICT |
| Other Organization Name | ST JOHN'S MEDICAL CENTER PHARMACY |
| Practice Address |
625 E Broadway Ave Jackson WY 83001-8642 |
| Mailing Address |
Po Box 428 Jackson WY 83001-0428 |
| Practice Telephone | 3077396172 |
| Practice Fax Number | 3077397698 |
| Mailing Telephone | 3077396172 |
| Mailing Fax Number | 3077397698 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-12-19 |
| Authorized Official Name | ALISA JEAN LANE (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 3077397641 |
| Is Organization Subpart | Y |
| Parent Organization Name | TETON COUNTY HOSPITAL DISTRICT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
5201102 | WY | Suppliers |
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
5201102 | WY | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 106299907 | 05 |
| Other Name | Type Code |
|---|---|
| St John's Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952823783 | Teton County Hospital District | Pharmacy | 555 E Broadway Ave Ste 212, Jackson, WY 83001-8640 | 2017-07-13 |
| 1457665333 | Teton County Hospital District | General Practice | Box 428 625 E Broadway Ave, Jackson, WY 83001-8642 | 2010-08-03 |
| 1679859797 | Teton County Hospital District | General Practice | 852 Valley Centre Dr, Driggs, ID 83422-5005 | 2011-11-03 |
| 1821317595 | Teton County Hospital District | Emergency Medicine | 625 E Broadway Ave, Jackson Hole, WY 83001-8642 | 2010-05-20 |
| 1487818605 | Teton County Hospital District | General Practice | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2008-07-16 |
| 1881896694 | Teton County Hospital District | General Acute Care Hospital | 625 East Broadway, Jackson, WY 83001 | 2007-06-04 |
| 1801929997 | Teton County Hospital District | Medicare Defined Swing Bed Unit | 625 E Broadway, Jackson, WY 83001-0428 | 2007-03-14 |
| 1215064985 | Teton County Hospital District | Skilled Nursing Facility | 625 East Broadway, Jackson, WY 83001-8642 | 2007-02-28 |
| 1194744235 | Teton County Hospital District | Case Management | 555 E Broadway Ave, Ste 115, Jackson, WY 83001-8640 | 2006-07-19 |
| 1568493989 | Teton County Hospital District | Hospice Care, Community Based | 555 E Broadway Ave, Suite #115, Jackson, WY 83001-8640 | 2006-07-05 |
| Street Address |
625 E BROADWAY AVE |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679534432 | Lars T Conway | Pathology | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2006-03-31 |
| 1154969251 | Michelle Robertson | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-19 |
| 1942848072 | Anna Sigrid Eide | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-19 |
| 1104464734 | Lisa Lauritzen Smith | Dietitian, Registered | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-12-13 |
| 1598325193 | Katrina Rush | Occupational Therapist | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2019-06-17 |
| 1669949590 | Elizabeth Smith Dannewald | Nurse Practitioner | 625 E Broadway Ave, Jackson, WY 83001 | 2018-10-29 |
| 1528533973 | Hanna Kirsten | Occupational Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-10-11 |
| 1891270500 | Jamie Loomis | Physical Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-09-27 |
| 1942784806 | Jared Travis Martin | Physical Therapy Assistant | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-09-17 |
| 1891274320 | Wendy Carbone | Physical Therapist | 625 E Broadway Ave, Jackson, WY 83001-8642 | 2018-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| 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 |
|---|---|---|---|---|
| 1689165482 | Georgia Diagnostic & Classification Prison Pharmacy | Pharmacy | 2978 Highway 36 W, Jackson, GA 30233-6150 | 2018-05-29 |
| 1962999789 | State Veterans Affairs Board | Pharmacy | 4607 Lindbergh Dr, Jackson, MS 39209-3855 | 2018-04-17 |
| 1811039704 | Jackson-madison County General Hospital | Pharmacy | 708 W Forest Ave, Jackson, TN 38301-3901 | 2007-02-14 |
| 1003979386 | St. Dominic-jackson Memorial Hospital | Pharmacy | 969 Lakeland Dr, Jackson, MS 39216-4606 | 2006-12-18 |
| 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 |
Please comment or provide details below to improve the information on TETON COUNTY HOSPITAL DISTRICT.
| 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.