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Organization
ELMORE MEDICAL CENTER HOSPITAL DISTRICT
Active
Organization
ELMORE MEDICAL CENTER HOSPITAL DISTRICT
Active
Other names
Trinity Mountain Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG MAUER (CEO)
(208) 580-2677
Entity
Organization
Contact information
Practice address
465 MCKENNA DR, MOUNTAIN HOME, ID 83647-2143
(208) 587-9703
(208) 580-9812
Mailing address
465 MCKENNA DR, MOUNTAIN HOME, ID 83647-2143
(208) 587-9703
(208) 580-9812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/18/2006
Last updated
08/22/2020
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