Benewah Medical Center

NPI #1336135136 in Plummer, Idaho

Provider Information

NPI Number
1336135136
Entity Type
Organization
Organization Name
Benewah Medical Center
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Sep 27, 2005
Last Updated
Mar 29, 2018

Practice Location

Address
427 N 12TH ST
State
Idaho
ZIP Code
83851
Phone
(208) 686-1931

Authorized Official

Name
PAUL LEROY BERGLAND
Title
CHIEF FINANCIAL OFFICER
Phone
(208) 686-5162

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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