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GRITMAN MEDICAL CENTER INC. NPI 1538634522


NPI Information

NPI: 1538634522
Provider Name: GRITMAN MEDICAL CENTER, INC.

Doing Business As: MOSCOW FAMILY MEDICINE CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 13D0522286

Address:
623 S MAIN ST STE 1
MOSCOW, ID
ZIP 83843
Phone: (208) 882-2011
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GRITMAN MEDICAL CENTER, INC. is a family medicine in Moscow, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GRITMAN MEDICAL CENTER, INC. NPI is 1538634522. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Moscow Family Medicine Clinic.

The provider's business location address is:

623 S MAIN ST STE 1
MOSCOW, ID
ZIP 83843-042
Phone: (208) 882-2011
Fax: (208) 883-1853

The provider's authorized official is Danielle Lynas .
The authorized official title is Cfo and has the following contact phone number (208) 883-2220.

The CLIA number assigned to this NPI record is 13D0522286 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/5/2018 and was last updated on 10/15/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
139OTHERIDAHOSTATE OF IDAHO LICENSE

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: 11/14/2023

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