Organization
HTI PHYSICIAN SERVICES OF UTAH INC
Active
Parent organization
WEST VALLEY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST VALLEY MEDICAL CENTER
Authorized official
MRS. JULIE TAYLOR (CEO)
(208) 455-3718
Entity
Organization
Contact information
Practice address
112 S PLYMOUTH STREET, NEW PLYMOUTH, ID 83655-0048
(208) 278-3406
Mailing address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104869965
—
ID
Enumeration date
06/13/2006
Last updated
10/26/2011
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