Health West Aberdeen Clinic | |
330 N Main Aberdeen ID 83210-0419 | |
(208) 397-4126 | |
(208) 397-4176 |
Full Name | Health West Aberdeen Clinic |
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Speciality | Clinic/Center |
Location | 330 N Main, Aberdeen, Idaho |
Authorized Official Name and Position | Mindy Benedetti (CEO) |
Authorized Official Contact | 2082327862 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Health West Aberdeen Clinic Po Box 2377 Pocatello ID 83206-2377 Ph: (208) 232-7862 | Health West Aberdeen Clinic 330 N Main Aberdeen ID 83210-0419 Ph: (208) 397-4126 |
NPI Number | 1295734796 |
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Provider Enumeration Date | 07/18/2005 |
Last Update Date | 08/17/2020 |
Medicare PECOS PAC ID | 4981500931 |
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Medicare Enrollment ID | O20061102000193 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295734796 | NPI | - | NPPES |
88633 | Other | ID | BLUE CROSS CLINIC NUMBER |
002445800 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | M7806 (Idaho) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |