| Southfork Healthcare | |
|
166 Elk Path Swan Valley ID 83449-0101 | |
| (208) 360-1997 | |
| Not Available |
| Full Name | Southfork Healthcare |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 166 Elk Path, Swan Valley, Idaho |
| Authorized Official Name and Position | Wendy Swope (ADMINISTRATOR) |
| Authorized Official Contact | 2083601997 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southfork Healthcare Po Box 101 Swan Valley ID 83449-0101 Ph: (208) 360-1997 | Southfork Healthcare 166 Elk Path Swan Valley ID 83449-0101 Ph: (208) 360-1997 |
| NPI Number | 1134462856 |
|---|---|
| Provider Enumeration Date | 04/01/2013 |
| Last Update Date | 05/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134462856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |