Organization
BONNER GENERAL HOSPITAL, INC.
Active
Other names
Bonner General Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL LYNN RICKARD (CEO)
(208) 265-1100
Entity
Organization
Contact information
Practice address
520 N 3RD AVE, SANDPOINT, ID 83864-1507
(208) 265-1101
(208) 265-1277
Mailing address
520 N 3RD AVE, SANDPOINT, ID 83864-1507
(208) 265-1101
(208) 265-1277
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
22
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004580
REGENCE BLUE SHIELD 1500
ID
01
—
000010004581
REGENCE BLUE SHIELD 1500
ID
01
—
000010004582
REGENCE BLUE SHIELD
ID
01
—
000010004583
REGENCE BLUE SHIELD UB92
ID
01
—
00067
BLUE CROSS UB92
ID
05
—
002274000
—
ID
05
—
002406400
—
ID
01
—
0027647
DEPT OF LABOR UB92
WA
01
—
0146625
DEPT OF LABOR 1500
WA
05
—
0354783
—
MT
05
—
0410280
—
MT
05
—
3300423
—
WA
05
—
7027337
—
WA
05
—
7106958
—
WA
01
—
8K388
BLUE CROSS 1500
ID
Enumeration date
04/27/2006
Last updated
03/16/2010
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