Elmore Medical Center Specialty Physician Group

LBN: Elmore Medical Center Specialty Physician Group
Elmore Medical Center Specialty Physician Group is an health care organization with primary practice located at 890 N 6Th E , Mountain Home ID 83647-2206. The organization recently has only one registered license in Hospitals / Critical Access, which is considered as the primary health care specialty. Elmore Medical Center Specialty Physician Group can be contacted via phone (208) 587-8401, or through Janousek, Mary E via phone (208) 587-8401.

Contact Information

Primary practice address
890 N 6Th E Mountain Home ID 83647-2206
Phone: (208) 587-8401
Fax: (208) 587-8406
Website:
Map and Directions
Authorized official contact:
Name: Janousek, Mary E
Phone: (208) 587-8401

Health care specialties

SpecialtyCodeLicense #State
Hospitals / Critical Access 282NC0060X

Profile Details

NPI number 1417122821
LBN Legal business name Elmore Medical Center Specialty Physician Group
DBA Doing business as
Authorized official Janousek, Mary E
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 25th, 2008
Last updated May 28th, 2009 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1417122821 NPPES
Idaho Other 000010149755 BLUE SHIELD PROF NUMBER
Idaho Other 000014148578 BLUE SHIELD PROF NUMBER
Idaho MEDICAID 002860700 BLUE SHIELD PROF NUMBER
Idaho Other 8K594 BLUE SHIELD PROF NUMBER

Popular Providers