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Organization
KOOTENAI HEALTH, INC.
Active
Organization
KOOTENAI HEALTH, INC.
Active
Other names
Kootenai Clinics Cancer Services Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JON NESS (CEO)
(208) 625-5081
Entity
Organization
Contact information
Practice address
700 W IRONWOOD DR, COEUR D ALENE, ID 83814-2656
(208) 625-5670
(208) 625-5669
Mailing address
700 W IRONWOOD DR, STE 228, COEUR D ALENE, ID 83814-2656
(208) 625-5670
(208) 625-5669
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0002X
Clinic Pharmacy
Primary
1198LS
ID
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073835591
—
ID
01
—
2124398
PK
—
Enumeration date
02/25/2010
Last updated
01/05/2024
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