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Organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Active
Organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Active
Other names
Bear Lake Family Care and OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
JILL RASMUSSEN (PFS ASSISSTANT)
(208) 847-4378
Entity
Organization
Contact information
Practice address
465 WASHINGTON ST, MONTPELIER, ID 83254-1544
(208) 847-4495
Mailing address
164 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-1630
(208) 847-2221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
NULL
Other
Enumeration date
03/19/2009
Last updated
10/17/2016
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