| Glenns Ferry Health Center, Inc. | |
|
560 E Jackson St Mountain Home ID 83647-2824 | |
| (208) 587-3988 | |
| Not Available |
| Full Name | Glenns Ferry Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 560 E Jackson St, Mountain Home, Idaho |
| Authorized Official Name and Position | Sharlet Wilson (EXECUTIVE ASSISTANT) |
| Authorized Official Contact | 2086967203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenns Ferry Health Center, Inc. 2280 American Legion Blvd Mountain Home ID 83647-3142 Ph: (208) 587-3988 | Glenns Ferry Health Center, Inc. 560 E Jackson St Mountain Home ID 83647-2824 Ph: (208) 587-3988 |
| NPI Number | 1881252344 |
|---|---|
| Provider Enumeration Date | 05/30/2019 |
| Last Update Date | 02/10/2020 |
| Certification Date | 02/10/2020 |
| Medicare PECOS PAC ID | 5496656894 |
|---|---|
| Medicare Enrollment ID | O20191004000125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881252344 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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