Organization
MADISON CO MEMORIAL HOSPITAL
Active
Parent organization
MADISON CO MEMORIAL HOSPITAL
Other names
Madison Memorial Rexburg Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MADISON CO MEMORIAL HOSPITAL
Authorized official
RACHEL GONZALES DM, RN, RODP (CHIEF EXECUTIVE OFFICER)
(208) 359-6900
Entity
Organization
Contact information
Practice address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 356-5401
(208) 356-3111
Mailing address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 356-5401
(208) 356-3111
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40
ID
Other
Enumeration date
11/02/2015
Last updated
10/23/2023
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