| State Hospital South Medical Clinic | |
|
700 E. Alice Box 400 Blackfoot ID 83221-0400 | |
| (208) 785-1200 | |
| (208) 785-8518 |
| Full Name | State Hospital South Medical Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 700 E. Alice, Blackfoot, Idaho |
| Authorized Official Name and Position | Lynn D Shields (PATIENT ACCOUNTS SPECIALIST) |
| Authorized Official Contact | 2087858462 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| State Hospital South Medical Clinic 700 E. Alice Po Box 400 Blackfoot ID 83221-0400 Ph: (208) 785-1200 | State Hospital South Medical Clinic 700 E. Alice Box 400 Blackfoot ID 83221-0400 Ph: (208) 785-1200 |
| NPI Number | 1538225545 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 07/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538225545 | NPI | - | NPPES |
| 002823200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 17 (Idaho) | Primary |
Idaho Physicians Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3800 | |
Blackfoot Medical Clinic Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
Blackfoot Medical Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 Fax: 208-785-8185 | |
Intercept Systems, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 N 700 W, Blackfoot, ID 83221 Phone: 208-201-0795 | |
Peak Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1495 Parkway Dr Ste C, Blackfoot, ID 83221 Phone: 208-643-4231 Fax: 208-643-4235 | |
Cedar Creek Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-782-3700 | |
Community Family Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1491 Parkway Dr, Blackfoot, ID 83221 Phone: 208-782-0500 Fax: 844-328-7224 |