GLENNS FERRY HEALTH CENTER INC. NPI 1518097047

NPI Information

NPI: 1518097047
Provider Name: GLENNS FERRY HEALTH CENTER, INC.

Doing Business As: DESERT SAGE HEALTH CENTERS

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
120 DESERT SAGE WAY
MOUNTAIN HOME, ID
ZIP 83647
Phone: (208) 587-3988
Get Directions

GLENNS FERRY HEALTH CENTER, INC. is a federally qualified health center (fqhc) clinic center in Mountain Home, ID. GLENNS FERRY HEALTH CENTER, INC. NPI is 1518097047. The provider is registered as an organization entity type.
The provider Is Doing Business As Desert Sage Health Centers.

The provider's business location address is:

120 DESERT SAGE WAY
MOUNTAIN HOME, ID
ZIP 83647-038
Phone: (208) 587-3988
Fax: (208) 587-3324

The provider's authorized official is Mary Ferguson .
The authorized official title is Ceo and has the following contact phone number (208) 696-7216.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 3/7/2024.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		IDAHO	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	805288500	MEDICAID	IDAHO
2	86645	OTHER	IDAHO	BLUE CROSS OF IDAHO
3	MEDICARE RAILROAD	OTHER		CP8711

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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