| Shoshone Medical Center | |
|
25 Jacobs Gulch Rd Kellogg ID 83837-2023 | |
| (208) 784-4612 | |
| (208) 786-1019 |
| Full Name | Shoshone Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 25 Jacobs Gulch Rd, Kellogg, Idaho |
| Authorized Official Name and Position | Donja C Erdman (CFO) |
| Authorized Official Contact | 2087841221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoshone Medical Center 25 Jacobs Gulch Rd Kellogg ID 83837-2023 Ph: (208) 784-1228 | Shoshone Medical Center 25 Jacobs Gulch Rd Kellogg ID 83837-2023 Ph: (208) 784-4612 |
| NPI Number | 1487272399 |
|---|---|
| Provider Enumeration Date | 07/07/2020 |
| Last Update Date | 04/27/2021 |
| Medicare PECOS PAC ID | 6103739107 |
|---|---|
| Medicare Enrollment ID | O20200902002026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487272399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mountain Health Services Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 740 Mckinley Ave, Kellogg, ID 83837 Phone: 208-783-1267 Fax: 208-786-4471 | |
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 |