Cascade Medical Center Hospital District | |
402 Lake Cascade Pkwy Cascade ID 83611-7702 | |
(208) 382-4242 | |
Not Available |
Full Name | Cascade Medical Center Hospital District |
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Speciality | Clinic/Center |
Location | 402 Lake Cascade Pkwy, Cascade, Idaho |
Authorized Official Name and Position | Sarah Hasbrouck (BUSINESS OFFICE MANAGER) |
Authorized Official Contact | 2084085025 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cascade Medical Center Hospital District Po Box 1330 Cascade ID 83611-1330 Ph: (208) 382-4242 | Cascade Medical Center Hospital District 402 Lake Cascade Pkwy Cascade ID 83611-7702 Ph: (208) 382-4242 |
NPI Number | 1003988825 |
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Provider Enumeration Date | 11/15/2006 |
Last Update Date | 02/13/2024 |
Medicare PECOS PAC ID | 6103739719 |
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Medicare Enrollment ID | O20040309001351 |
Identifier | Type | State | Issuer |
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1003988825 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Ronald K Ellsworth |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245556141 PECOS PAC ID: 3971778358 Enrollment ID: I20130723000595 |
Provider Name | Chantell Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720432230 PECOS PAC ID: 4587951199 Enrollment ID: I20160926001820 |