| Salmon River Clinic Hospital District | |
|
110 Niece Avenue Stanley ID 83278-0129 | |
| (208) 774-3565 | |
| Not Available |
| Full Name | Salmon River Clinic Hospital District |
|---|---|
| Speciality | Family Medicine |
| Location | 110 Niece Avenue, Stanley, Idaho |
| Authorized Official Name and Position | Amy Mercantini Klingler (PA/ADMINISTRATOR) |
| Authorized Official Contact | 2087743565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salmon River Clinic Hospital District Po Box 129 Stanley ID 83278-0129 Ph: (208) 774-3565 | Salmon River Clinic Hospital District 110 Niece Avenue Stanley ID 83278-0129 Ph: (208) 774-3565 |
| NPI Number | 1083796569 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 03/20/2026 |
| Medicare PECOS PAC ID | 6204745078 |
|---|---|
| Medicare Enrollment ID | O20030425000035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083796569 | NPI | - | NPPES |
| 806387200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-4162 (Idaho) | Primary |
| 363A00000X | Physician Assistant | PA-492 (Idaho) | Secondary |