| Shoshone Family Medical Center | |
|
113 S Apple St Shoshone ID 83352-5287 | |
| (208) 886-2222 | |
| Not Available |
| Full Name | Shoshone Family Medical Center |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 113 S Apple St, Shoshone, Idaho |
| Authorized Official Name and Position | Keith E Davis (OWNER) |
| Authorized Official Contact | 2088862224 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoshone Family Medical Center Po Box 609 Shoshone ID 83352-0609 Ph: () - | Shoshone Family Medical Center 113 S Apple St Shoshone ID 83352-5287 Ph: (208) 886-2222 |
| NPI Number | 1972673218 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 03/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972673218 | NPI | - | NPPES |
| 806290300 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Southern Idaho Diabetes Education Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Nw Rail St, Shoshone, ID 83352 Phone: 208-944-4747 Fax: 208-886-2634 | |
Physician Management Services Of Idaho, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 S Apple St, Shoshone, ID 83352 Phone: 888-829-8550 |