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Organization
MCCALL MEMORIAL HOSPITAL
Active
Organization
MCCALL MEMORIAL HOSPITAL
Active
Parent organization
MCCALL MEMORIAL HOSPITAL
Other names
McCall Therapy Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCCALL MEMORIAL HOSPITAL
Authorized official
MR. MATT GROENIG (VP FINANCE)
(208) 634-2221
Entity
Organization
Contact information
Practice address
1010 STATE STREET, MCCALL, ID 83638-3704
(208) 634-2221
(208) 634-7112
Mailing address
1000 STATE ST, MCCALL, ID 83638-3704
(208) 634-2221
(208) 634-7112
Taxonomy
Speciality
Code
Description
License number
State
261QC0050X
Critical Access Hospital Clinic/Center
Primary
11
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147637
REGENCE CLINIC GRP #
ID
05
—
806937700
—
ID
05
—
807424900
—
ID
01
—
8J612
BLUE CROSS CLINIC GRP #
ID
Enumeration date
08/09/2006
Last updated
05/06/2010
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