Organization
LOST RIVERS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD HUERTA (CEO)
(208) 527-8205
Entity
Organization
Contact information
Practice address
551 HIGHLAND DR, ARCO, ID 83213-9771
(208) 527-8206
(208) 527-3430
Mailing address
PO BOX 145, ARCO, ID 83213-0145
(208) 527-8206
(208) 527-3430
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
45
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002300900
—
ID
Enumeration date
07/13/2005
Last updated
05/01/2017
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