# BOUNDARY COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215082565
- **Authorized official:** APRIL D BENNETT (CEO)
- **Authorized official phone:** (208) 267-4850

## Contact information

- **Practice address:** 6640 KANIKSU ST, BONNERS FERRY, ID 83805-7532
- **Practice address phone:** (208) 267-4850
- **Practice address fax:** (208) 267-2202
- **Mailing address:** 6640 KANIKSU ST, BONNERS FERRY, ID 83805-7532
- **Mailing address phone:** (208) 267-4850
- **Mailing address fax:** (208) 267-2202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 745 HP & 1172 PA | NULL | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 06/28/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002810400 | — | ID |