Organization
REXBURG MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ZOLLINGER (ADMINISTRATOR)
(208) 356-5401
Entity
Organization
Contact information
Practice address
393 E 2ND N, REXBURG, ID 83440
(208) 356-5401
(208) 356-3111
Mailing address
393 E 2ND N, REXBURG, ID 83440
(208) 356-5401
(208) 356-3111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4211
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29920
BLUE SHIELD OF IDAHO
ID
01
—
8981-3
BLUE CROSS
ID
Enumeration date
10/02/2006
Last updated
08/22/2020
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