| North Canyon Mountain Home Clinic | |
|
840 N 4th E Mountain Home ID 83647-2166 | |
| (208) 934-8829 | |
| (208) 934-4874 |
| Full Name | North Canyon Mountain Home Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 840 N 4th E, Mountain Home, Idaho |
| Authorized Official Name and Position | Tim Powers (CEO) |
| Authorized Official Contact | 2089348765 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Canyon Mountain Home Clinic 267 N Canyon Dr Gooding ID 83330-5500 Ph: (208) 934-4433 | North Canyon Mountain Home Clinic 840 N 4th E Mountain Home ID 83647-2166 Ph: (208) 934-8829 |
| NPI Number | 1649759374 |
|---|---|
| Provider Enumeration Date | 08/13/2018 |
| Last Update Date | 08/13/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649759374 | NPI | - | NPPES |
| 1184932584 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Idaho) | Primary |
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Doctors Clinic Of Elmore County Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2000 American Legion Blvd, Mountain Home, ID 83647 Phone: 208-587-1500 Fax: 208-587-3180 | |
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Desert Sage Health Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 120 Desert Sage Way, Mountain Home, ID 83647 Phone: 208-587-3988 Fax: 208-587-3324 | |
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