St. Mary's Hospital, Inc.

NPI #1174577100 in Cottonwood, Idaho

Provider Information

NPI Number: 1174577100
Entity Type: Organization
Organization Name: St. Mary's Hospital, Inc.
Primary Specialty: Family Medicine
Enumeration Date: May 22, 2006
Last Updated: Jan 27, 2022

Practice Location

Address: 701 LEWISTON ST
City: Cottonwood
State: Idaho
ZIP Code: 83522-9750
Phone: (208) 962-3267

Authorized Official

Name: LENNE BONNER
Title: CEO
Phone: (208) 476-4555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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