| St. Mary's Hospital, Inc. | |
|
518 Oak Kamiah ID 83536 | |
| (208) 935-2585 | |
| (208) 935-0945 |
| Full Name | St. Mary's Hospital, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 518 Oak, Kamiah, Idaho |
| Authorized Official Name and Position | Lenne Bonner (CEO) |
| Authorized Official Contact | 2084764555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mary's Hospital, Inc. 2003 Kootenai Health Way Coeur D Alene ID 83814-6051 Ph: (208) 625-5085 | St. Mary's Hospital, Inc. 518 Oak Kamiah ID 83536 Ph: (208) 935-2585 |
| NPI Number | 1568400562 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 01/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568400562 | NPI | - | NPPES |
| 002283501 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |