IDAHO DEPT OF HEALTH & WELFARE REG II CMH MOSCOW NPI 1720116551

NPI Information

NPI: 1720116551
Provider Name: IDAHO DEPT OF HEALTH & WELFARE REG II CMH MOSCOW
Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
1350 TROY HWY
MOSCOW, ID
ZIP 83543
Phone: (208) 882-0562
Get Directions

IDAHO DEPT OF HEALTH & WELFARE REG II CMH MOSCOW is a rehabilitation clinic center in Moscow, ID. IDAHO DEPT OF HEALTH & WELFARE REG II CMH MOSCOW NPI is 1720116551. The provider is registered as an organization entity type.

The provider's business location address is:

1350 TROY HWY
MOSCOW, ID
ZIP 83543-995
Phone: (208) 882-0562
Fax: (208) 882-8575

The provider's authorized official is Vicki R. Malone .
The authorized official title is Program Manager and has the following contact phone number (208) 799-4440.

The enumeration date for this NPI number is 3/1/2007 and was last updated on 8/22/2020.

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	261QR0400X	Clinic/Center	Rehabilitation			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	000010018450	OTHER		BLUE SHIELD
2	8073500	MEDICAID	IDAHO
3	HW140	OTHER		BLUE CROSS OF IDAHO

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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