| St Lukes Rhc - Trinity Mountain | |
|
465 Mckenna Dr Mountain Home ID 83647-2143 | |
| (208) 587-9703 | |
| Not Available |
| Full Name | St Lukes Rhc - Trinity Mountain |
|---|---|
| Speciality | Clinic/Center |
| Location | 465 Mckenna Dr, Mountain Home, Idaho |
| Authorized Official Name and Position | Kathryn Fowler (SENIOR VP, CFO) |
| Authorized Official Contact | 2083818717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Lukes Rhc - Trinity Mountain Po Box 640 Boise ID 83701-0640 Ph: (208) 381-2222 | St Lukes Rhc - Trinity Mountain 465 Mckenna Dr Mountain Home ID 83647-2143 Ph: (208) 587-9703 |
| NPI Number | 1417297821 |
|---|---|
| Provider Enumeration Date | 02/21/2013 |
| Last Update Date | 12/08/2022 |
| Medicare PECOS PAC ID | 4981878402 |
|---|---|
| Medicare Enrollment ID | O20161109002873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417297821 | NPI | - | NPPES |
| 1369110 | Other | ID | MEDICARE / MULTI SPECIALTY CLINIC |
| 133999 | Other | ID | MEDICARE / RHC |
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