| Valley Medical Center, Pllc | |
|
2315 8th St Lewiston ID 83501-7301 | |
| (208) 746-1383 | |
| (208) 746-6348 |
| Full Name | Valley Medical Center, Pllc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2315 8th St, Lewiston, Idaho |
| Authorized Official Name and Position | David L Schlactus (CEO) |
| Authorized Official Contact | 2082983100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Medical Center, Pllc 2315 8th St Lewiston ID 83501-7301 Ph: (208) 746-1383 | Valley Medical Center, Pllc 2315 8th St Lewiston ID 83501-7301 Ph: (208) 746-1383 |
| NPI Number | 1942227699 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 12/12/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942227699 | NPI | - | NPPES |
| 8A950 | Other | ID | BLUE CROSS OF ID |
| 1942227699 | Other | ID | REGENCE BLUESHIELD |
| 1942227699 | Medicaid | ID | |
| 7081938 | Medicaid | WA | |
| 31250 | Other | WA | LABOR & INDUSTRIES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 04-206454 (Idaho) | Primary |
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