| Ashton Memorial, Inc. | |
|
1301 E 17th St Ste 4 Idaho Falls ID 83404-6273 | |
| (208) 523-0787 | |
| (208) 523-3175 |
| Full Name | Ashton Memorial, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1301 E 17th St Ste 4, Idaho Falls, Idaho |
| Authorized Official Name and Position | Suzanne Brady (HR DIRECTOR) |
| Authorized Official Contact | 2056527461 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashton Memorial, Inc. 1301 E 17th St Ste 4 Idaho Falls ID 83404-6273 Ph: (208) 523-0787 | Ashton Memorial, Inc. 1301 E 17th St Ste 4 Idaho Falls ID 83404-6273 Ph: (208) 523-0787 |
| NPI Number | 1245670793 |
|---|---|
| Provider Enumeration Date | 06/28/2013 |
| Last Update Date | 06/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245670793 | NPI | - | NPPES |
| 1003907163 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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