OLD FAITHFUL CLINIC – NPI #1053493403
Clinic/Center

OLD FAITHFUL CLINIC is an AHC clinic located in YELLOWSTONE NATIONAL PARK, WY. NPPES has assigned the NPI number 1053493403 to OLD FAITHFUL CLINIC on October 19, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “OLD FAITHFUL CLINIC” is a dba name, the actual legal business name for this organization is MEDCOR OF BARRINGTON, PC. The primary taxonomy selected by this provider is 261QU0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Urgent Care

The NPI profile was previously updated about 19 years ago on Nov 19, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for OLD FAITHFUL CLINIC below.

NPI Profile for
MEDCOR OF BARRINGTON, PC

NPI Number
1053493403
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MEDCOR OF BARRINGTON, PC
Doing Business As (dba): OLD FAITHFUL CLINIC
Primary location
1 OLD FAITHFUL HOT SPRINGS
YELLOWSTONE NATIONAL PARK, WY 82190
Phone: (307) 545-7325 Fax: (307) 545-7302
Mailing address
PO BOX 2058
YELLOWSTONE NATIONAL PARK, WY 82190-2058
Phone: (307) 545-7325 Fax: (307) 545-7302
Organization Subpart
No
Authorized Official
THOMAS GLIMP
MEDICAL DIRECTOR
Phone: (815) 363-9500
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QU0200X
- Clinic/Center / Urgent Care (Primary)		 IL

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.