Organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Active
Organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Active
Other names
BEAR LAKE INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE BINGHAM (CONTRACT MANAGEMENT)
(208) 847-4327
Entity
Organization
Contact information
Practice address
166 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-1110
(208) 847-0228
Mailing address
166 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-1110
(208) 847-0228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M7743
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806833500
—
ID
Enumeration date
04/23/2007
Last updated
12/17/2012
Update your record
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