St. Mary's Health | |
701 Lewiston St Cottonwood ID 83522-9750 | |
(208) 962-3267 | |
(208) 962-2313 |
Full Name | St. Mary's Health |
---|---|
Speciality | Family Medicine |
Location | 701 Lewiston St, Cottonwood, Idaho |
Authorized Official Name and Position | Lenne Bonner (CEO) |
Authorized Official Contact | 2084764555 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
St. Mary's Health 2003 Kootenai Health Way Coeur D Alene ID 83814-6051 Ph: (208) 625-5085 | St. Mary's Health 701 Lewiston St Cottonwood ID 83522-9750 Ph: (208) 962-3267 |
NPI Number | 1174577100 |
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Provider Enumeration Date | 05/22/2006 |
Last Update Date | 01/27/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174577100 | NPI | - | NPPES |
002283500 | Medicaid | ID | |
805066400 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Idaho) | Primary |
363L00000X | Nurse Practitioner | (Idaho) | Secondary |