| Challis Area Health Center Incorporated | |
|
611 Clinic Rd Challis ID 83226 | |
| (208) 879-4351 | |
| (208) 879-5216 |
| Full Name | Challis Area Health Center Incorporated |
|---|---|
| Speciality | Clinic/Center |
| Location | 611 Clinic Rd, Challis, Idaho |
| Authorized Official Name and Position | Sharlene Miller (CFO) |
| Authorized Official Contact | 2088792883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Challis Area Health Center Incorporated Po Box 980 Challis ID 83226-0980 Ph: (208) 879-4391 | Challis Area Health Center Incorporated 611 Clinic Rd Challis ID 83226 Ph: (208) 879-4351 |
| NPI Number | 1013387877 |
|---|---|
| Provider Enumeration Date | 10/05/2015 |
| Last Update Date | 07/21/2020 |
| Medicare PECOS PAC ID | 2769779776 |
|---|---|
| Medicare Enrollment ID | O20160919002630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013387877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Richard F Paris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255387874 PECOS PAC ID: 0345298154 Enrollment ID: I20050112000406 |
| Provider Name | Kathryn A Woods |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083653661 PECOS PAC ID: 1254389067 Enrollment ID: I20050121000312 |
| Provider Name | Gay M Miremont |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134556814 PECOS PAC ID: 6709013386 Enrollment ID: I20131206000594 |
| Provider Name | Jp E Prouty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548689318 PECOS PAC ID: 2264651694 Enrollment ID: I20171006001464 |
| Provider Name | Marla Andrews |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659994580 PECOS PAC ID: 6406209923 Enrollment ID: I20240131001760 |
White Cloud Wellness Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 431 E. Main St., #994, Challis, ID 83226 Phone: 208-833-1313 Fax: 833-839-1195 |