Organization
ST. MARY'S HOSPITAL, INC.
Active
Other names
St. Mary's Health
Organization subpart
No
Provider details
NPI number
Authorized official
LENNE BONNER (CEO)
(208) 476-4555
Entity
Organization
Contact information
Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3267
(208) 962-2313
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-5085
(208) 625-5731
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
ID
363L00000X
Nurse Practitioner
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002283500
—
ID
05
—
805066400
—
ID
Enumeration date
05/22/2006
Last updated
01/27/2022
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