GRITMAN MEDICAL CENTER INC NPI 1750475380

NPI Information

NPI: 1750475380
Provider Name: GRITMAN MEDICAL CENTER INC

Doing Business As: KENDRICK CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
606 E MAIN ST
KENDRICK, ID
ZIP 83537
Phone: (208) 289-3841
Get Directions

GRITMAN MEDICAL CENTER INC is a rural health clinic center in Kendrick, ID. GRITMAN MEDICAL CENTER INC NPI is 1750475380. The provider is registered as an organization entity type.
The provider Is Doing Business As Kendrick Clinic.

The provider's business location address is:

606 E MAIN ST
KENDRICK, ID
ZIP 83537
Phone: (208) 289-3841
Fax: (208) 289-3961

The provider's authorized official is Harry Jasper .
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 13D0938809 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/3/2006 and was last updated on 2/14/2017.

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	261QR1300X	Clinic/Center	Rural Health	39	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	7118532	MEDICAID	WASHINGTON
2	000010138308	OTHER	IDAHO	REGENCE
3	805890000	MEDICAID	IDAHO
4	133997	MEDICARE PIN	IDAHO
5	8A612	OTHER	IDAHO	BLUE CROSS

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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