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Organization

KOOTENAI HEALTH, INC.

Active
Other names
Kootenai Clinics Cancer Services Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JON NESS (CEO)
(208) 625-5081
Entity
Organization

Contact information

Practice address
700 W IRONWOOD DR, COEUR D ALENE, ID 83814-2656
(208) 625-5670
(208) 625-5669
Mailing address
700 W IRONWOOD DR, STE 228, COEUR D ALENE, ID 83814-2656
(208) 625-5670
(208) 625-5669

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0002X
Clinic Pharmacy
Primary
1198LS
ID
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1073835591
ID
01
2124398
PK
Enumeration date
02/25/2010
Last updated
01/05/2024
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