# GRITMAN MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GRITMAN MEDICAL CENTER INC
- **Other names:** TROY CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1942567847
- **Legal business name:** GRITMAN MEDICAL CENTER INC
- **Authorized official:** MR. PATRICK MCCONNELL (CFO)
- **Authorized official phone:** (208) 883-2220

## Contact information

- **Practice address:** 412 S MAIN ST, TROY, ID 83871-0415
- **Practice address phone:** (208) 835-5550
- **Practice address fax:** (208) 883-6580
- **Mailing address:** 700 S MAIN ST, MOSCOW, ID 83843-3056
- **Mailing address phone:** (208) 882-4511
- **Mailing address fax:** (208) 883-6571

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 04/16/2012
- **Last updated:** 10/09/2016