BENEWAH MEDICAL CENTER NPI 1336135136

NPI Information

BENEWAH MEDICAL CENTER is a federally qualified health center (fqhc) clinic center in Plummer, ID. BENEWAH MEDICAL CENTER NPI is 1336135136. The provider is registered as an organization entity type.
The provider Is Doing Business As Marimn Health.

The provider's business location address is:

427 N 12TH ST
PLUMMER, ID
ZIP 83851
Phone: (208) 686-1931

The provider's authorized official is Paul Leroy Bergland .
The authorized official title is Chief Financial Officer and has the following contact phone number (208) 686-5162.

The CLIA number assigned to this NPI record is 13D0669093 - rural health clinic with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/27/2005 and was last updated on 3/29/2018.

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:

Other Identifiers

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.