| Xray Ekg | |
|
486 W 1st Ave Glenns Ferry ID 83623-2701 | |
| (208) 366-7416 | |
| (208) 366-2595 |
| Full Name | Xray Ekg |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 486 W 1st Ave, Glenns Ferry, Idaho |
| Authorized Official Name and Position | Sharlet Wilson (EXECUTIVE ASSISTANT) |
| Authorized Official Contact | 2086967203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Xray Ekg 120 Desert Sage Way Mountain Home ID 83647-1038 Ph: (208) 696-7203 | Xray Ekg 486 W 1st Ave Glenns Ferry ID 83623-2701 Ph: (208) 366-7416 |
| NPI Number | 1427259894 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 09/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427259894 | NPI | - | NPPES |
| 002550200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Glenns Ferry Health Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 486 W 1st Ave, Glenns Ferry, ID 83623 Phone: 208-366-7416 Fax: 208-587-3324 |