| Heritage Mountain Health Kellogg | |
|
740 Mckinley Ave Kellogg ID 83837-2693 | |
| (087) 831-2672 | |
| (844) 807-3782 |
| Full Name | Heritage Mountain Health Kellogg |
|---|---|
| Speciality | Clinic/Center |
| Location | 740 Mckinley Ave, Kellogg, Idaho |
| Authorized Official Name and Position | Michael Baker (CEO) |
| Authorized Official Contact | 2086205200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Mountain Health Kellogg Po Box 1387 Hayden ID 83835-1387 Ph: (208) 620-5200 | Heritage Mountain Health Kellogg 740 Mckinley Ave Kellogg ID 83837-2693 Ph: (087) 831-2672 |
| NPI Number | 1487076048 |
|---|---|
| Provider Enumeration Date | 01/15/2014 |
| Last Update Date | 08/24/2023 |
| Certification Date | 08/24/2023 |
| Medicare PECOS PAC ID | 2466353354 |
|---|---|
| Medicare Enrollment ID | O20140319000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487076048 | NPI | - | NPPES |
| 1378465 | Other | ID | MEDICARE PART B PTAN 1378465 |
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