| Eastern Idaho Regional Medical Center | |
|
2280 E 25th St Idaho Falls ID 83404-7542 | |
| (208) 227-2100 | |
| (208) 227-2368 |
| Full Name | Eastern Idaho Regional Medical Center |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 2280 E 25th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Doug Crabtree (CEO) |
| Authorized Official Contact | 2085296210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Idaho Regional Medical Center 3100 Channing Way Idaho Falls ID 83404-7533 Ph: (208) 529-6111 | Eastern Idaho Regional Medical Center 2280 E 25th St Idaho Falls ID 83404-7542 Ph: (208) 227-2100 |
| NPI Number | 1740287911 |
|---|---|
| Provider Enumeration Date | 07/04/2005 |
| Last Update Date | 09/09/2016 |
| Medicare PECOS PAC ID | 5597662981 |
|---|---|
| Medicare Enrollment ID | O20070629000197 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740287911 | NPI | - | NPPES |
| 114794303 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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