Organization
ST BENEDICTS FAMILY MEDICAL CENTER
Active
Organization
ST BENEDICTS FAMILY MEDICAL CENTER
Active
Other names
ST BENEDICTS FAMILY CLINIC-WENDELL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CURTIS MAIER (COO)
(208) 324-1122
Entity
Organization
Contact information
Practice address
280 W MAIN ST, WENDELL, ID 83355-5201
(208) 563-6663
(208) 536-5182
Mailing address
280 W MAIN ST, WENDELL, ID 83355-5201
(208) 563-6663
(208) 536-5182
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010142896
REGENCE BLUE SHIELD OF ID
ID
01
—
8G882
BLUE CROSS OF IDAHO
ID
Enumeration date
06/20/2006
Last updated
04/20/2008
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