MEMORIAL HOSPITAL - RADIOLOGY NPI 1639373772

NPI Information

NPI: 1639373772
Provider Name: MEMORIAL HOSPITAL - RADIOLOGY
Classification: General Acute Care Hospital - 282NC0060X
Entity Type: Organization

Specialization: Critical Access

Address:
645 E 5TH ST
WEISER, ID
ZIP 83672
Phone: (208) 549-0370
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MEMORIAL HOSPITAL - RADIOLOGY is a critical access general acute care hospital in Weiser, ID. MEMORIAL HOSPITAL - RADIOLOGY NPI is 1639373772. The provider is registered as an organization entity type.

The provider's business location address is:

645 E 5TH ST
WEISER, ID
ZIP 83672-202
Phone: (208) 549-0370
Fax: (208) 414-4267

The provider's authorized official is Wade Johnson .
The authorized official title is Ceo and has the following contact phone number (208) 549-4450.

The enumeration date for this NPI number is 6/13/2007 and was last updated on 1/29/2009.

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	282NC0060X	General Acute Care Hospital	Critical Access	32	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	000010027650	OTHER	IDAHO	BLUE SHIELD RADY
2	3032901	MEDICAID	WASHINGTON
3	002851300	MEDICAID	IDAHO
4	8K396	OTHER	IDAHO	BLUE CROSS GROUP
5	121244	MEDICAID	OREGON
6	1374372	MEDICARE ID-TYPE UNSPECIFIED	IDAHO	MEDICARE RADY

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: 5/5/2024

NPI Synchronization or Removal

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