Organization
MCCALL MEMORIAL HOSPITAL
Active
Parent organization
MCCALL MEMORIAL HOSPITAL
Other names
Donnelly Medical Clinic, a MMH Physician Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MCCALL MEMORIAL HOSPITAL
Authorized official
KAREN J KELLIE (PRESIDENT)
(208) 634-2221
Entity
Organization
Contact information
Practice address
454 WEST ROSEBERRY RD, SUITE 103, DONNELLY, ID 83615
(208) 325-4455
(208) 325-4466
Mailing address
1000 STATE ST, MCCALL, ID 83638-3704
(208) 634-2221
(208) 634-7112
Taxonomy
Speciality
Code
Description
License number
State
261QC0050X
Critical Access Hospital Clinic/Center
Primary
11
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010159605
REGENCE CLINIC NUMBER
ID
01
—
8M977
BLUE CROSS OF ID CLINIC
ID
Enumeration date
03/09/2007
Last updated
02/15/2008
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