| Desert Sage Health Centers | |
|
350 Main St. Grand View ID 83624 | |
| (208) 834-2929 | |
| (208) 587-3324 |
| Full Name | Desert Sage Health Centers |
|---|---|
| Speciality | Clinic/Center |
| Location | 350 Main St., Grand View, Idaho |
| Authorized Official Name and Position | Mary Ferguson (CEO) |
| Authorized Official Contact | 2086967216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Sage Health Centers 2280 American Legion Blvd Mountain Home ID 83647-3142 Ph: (208) 587-3988 | Desert Sage Health Centers 350 Main St. Grand View ID 83624 Ph: (208) 834-2929 |
| NPI Number | 1972633949 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 02/10/2020 |
| Medicare PECOS PAC ID | 5496656894 |
|---|---|
| Medicare Enrollment ID | O20080605000685 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972633949 | NPI | - | NPPES |
| 86645 | Other | ID | BLUE CROSS OF IDAHO |
| 002550600 | Medicaid | ID | |
| CP8711 | Other | ID | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Idaho) | Primary |