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Organization
SOUTHWEST IDAHO ADVANCED CARE HOSPITAL INC -A DELAWARE CORP-
Active
Organization
SOUTHWEST IDAHO ADVANCED CARE HOSPITAL INC -A DELAWARE CORP-
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDE DARBY BROCKETTE (CEO)
(505) 856-5300
Entity
Organization
Contact information
Practice address
6651 W FRANKLIN RD, BOISE, ID 83709
(505) 856-5300
Mailing address
6651 W FRANKLIN RD, BOISE, ID 83709
(505) 856-5300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
282E00000X
Long Term Care Hospital
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
09/11/2007
Last updated
08/17/2017
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