# TETON COUNTY HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TETON COUNTY HOSPITAL DISTRICT
- **Other names:** St. John's Four Peaks Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1679859797
- **Legal business name:** TETON COUNTY HOSPITAL DISTRICT
- **Authorized official:** JOHN J. KREN (CFO)
- **Authorized official phone:** (307) 739-7526

## Contact information

- **Practice address:** 852 VALLEY CENTRE DR, DRIGGS, ID 83422-5005
- **Practice address phone:** (208) 354-4757
- **Practice address fax:** (307) 354-4758
- **Mailing address:** PO BOX 4010, JACKSON, WY 83001-4010
- **Mailing address phone:** (307) 739-7391
- **Mailing address fax:** (307) 739-7549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 09-179 | WY | Yes |

## Other

- **Enumeration date:** 11/03/2011
- **Last updated:** 08/12/2013