| St. Mary's Grangeville Clinic | |
|
617 W North St Grangeville ID 83530-1239 | |
| (208) 962-3267 | |
| (208) 962-2313 |
| Full Name | St. Mary's Grangeville Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 617 W North St, Grangeville, Idaho |
| Authorized Official Name and Position | Michelle M Gates (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Contact | 2084768083 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mary's Grangeville Clinic 617 W North St Grangeville ID 83530-1239 Ph: (208) 962-3267 | St. Mary's Grangeville Clinic 617 W North St Grangeville ID 83530-1239 Ph: (208) 962-3267 |
| NPI Number | 1710203237 |
|---|---|
| Provider Enumeration Date | 04/08/2010 |
| Last Update Date | 10/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710203237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Idaho) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (Idaho) | Secondary |
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