| Mountain Health Services Pc | |
|
740 Mckinley Ave Kellogg ID 83837-2693 | |
| (208) 783-1267 | |
| (208) 786-4471 |
| Full Name | Mountain Health Services Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 740 Mckinley Ave, Kellogg, Idaho |
| Authorized Official Name and Position | Frederick R Haller (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2087831267 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Health Services Pc 740 Mckinley Ave Kellogg ID 83837-2693 Ph: (208) 783-1267 | Mountain Health Services Pc 740 Mckinley Ave Kellogg ID 83837-2693 Ph: (208) 783-1267 |
| NPI Number | 1164539912 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 02/14/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164539912 | NPI | - | NPPES |
| 002790500 | Medicaid | ID | |
| 000010006537 | Other | ID | REGENCE |
| CC9834 | Other | ID | RAILROAD MEDICARE |
| 8A570 | Other | ID | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M8355 (Idaho) | Primary |
Silver Valley Family Practice Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 Mckinley Ave, Kellogg, ID 83837 Phone: 208-783-0300 Fax: 208-783-0303 | |
Shoshone Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 25 Jacobs Gulch Rd, Kellogg, ID 83837 Phone: 208-784-4612 Fax: 208-786-1019 |