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Organization
BMH, INC.
Active
Organization
BMH, INC.
Active
Other names
Mountain River Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
LISA RUDOLPH (PSO SUPPORT SPECIALIST)
(208) 782-3992
Entity
Organization
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-5801
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-5801
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Enumeration date
06/27/2007
Last updated
02/18/2009
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