BENEWAH MEDICAL CENTER NPI 1336135136

NPI Information

  • NPI: 1336135136
  • Provider Name: BENEWAH MEDICAL CENTER
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: MARIMN HEALTH
  • CLIA Number: 13D1092732
  • Address: 427 N 12TH ST
    PLUMMER, ID
    ZIP 83851
  • Phone: (208) 686-1931

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NPI Details

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 13D1092732 - rural health clinic with a certificate type of Certificate of Waiver.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)131814IDAHOYes

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
1804166900MEDICAIDIDAHO
2805801300MEDICAIDIDAHO
30026771MEDICAIDIDAHO

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: 11/21/2025

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