Organization
CLEARWATER VALLEY HOSPITAL & CLINICS INC
Active
Parent organization
CLEARWATER VALLEY HOSPITAL & CLINICS INC
Other names
Clearwater Valley Hospital Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CLEARWATER VALLEY HOSPITAL & CLINICS INC
Authorized official
LENNE J BONNER (CFO)
(208) 476-4555
Entity
Organization
Contact information
Practice address
301 CEDAR ST, OROFINO, ID 83544-9029
(208) 476-4555
(208) 476-5385
Mailing address
301 CEDAR ST, OROFINO, ID 83544-9029
(208) 476-4555
(208) 476-5385
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805060900
—
ID
Enumeration date
06/02/2006
Last updated
05/08/2014
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