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301 Cedar St Orofino ID 83544-9029 | |
| (208) 476-4555 | |
| (208) 476-5385 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Cedar St, Orofino, Idaho |
| Authorized Official Name and Position | Lenne J Bonner (CEO) |
| Authorized Official Contact | 2084764555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2003 Kootenai Health Way Coeur D Alene ID 83814-6051 Ph: (208) 464-2578 | 301 Cedar St Orofino ID 83544-9029 Ph: (208) 476-4555 |
| NPI Number | 1033153739 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 01/27/2022 |
| Medicare PECOS PAC ID | 0547173346 |
|---|---|
| Medicare Enrollment ID | O20050628000452 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033153739 | NPI | - | NPPES |
| 805060600 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Idaho) | Primary |
Orofino Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 Cedar St, Orofino, ID 83544 Phone: 208-476-4555 Fax: 208-476-5385 | |