IDAHODHWBH3 CALDWELL CMH PSR NPI 1063540359

NPI Information

NPI: 1063540359
Provider Name: IDAHODHWBH3 CALDWELL CMH PSR
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
3402 FRANKLIN RD
CALDWELL, ID
ZIP 83605
Phone: (208) 459-0092
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IDAHODHWBH3 CALDWELL CMH PSR is a rehabilitation clinic center in Caldwell, ID. IDAHODHWBH3 CALDWELL CMH PSR NPI is 1063540359. The provider is registered as an organization entity type.

The provider's business location address is:

3402 FRANKLIN RD
CALDWELL, ID
ZIP 83605-932
Phone: (208) 459-0092
Fax: (208) 454-7714

The provider's authorized official is Todd L Hurt .
The authorized official title is Field Operations Manager and has the following contact phone number (208) 455-7057.

The enumeration date for this NPI number is 3/1/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	HW348	OTHER		BLUE CROSS OF IDAHO
2	000010018824	OTHER		BLUESHIELD
3	0028416	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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