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Organization
MADISON CO MEMORIAL HOSPITAL
Active
Organization
MADISON CO MEMORIAL HOSPITAL
Active
Other names
Madison Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL GONZALES DM, RN, RODP (CHIEF EXECUTIVE OFFICER)
(208) 359-6900
Entity
Organization
Contact information
Practice address
450 E. MAIN, REXBURG, ID 83440
(208) 359-6900
(208) 359-9879
Mailing address
450 E MAIN ST, REXBURG, ID 83440-2048
(208) 359-6900
(208) 359-9879
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
40
ID
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006291
REGENCE BLUE SHIELD OF ID
ID
01
—
00109
BLUE CROSS OF IDAHO
ID
05
—
002855700
—
ID
05
—
2855700
—
ID
Enumeration date
06/11/2006
Last updated
02/02/2026
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