Organization
CLEARWATER VALLEY HOSPITAL & CLINICS INC.
Active
Other names
Anesthesia group
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA M MEACHAM (BUSINESS OFFICE MANAGER)
(208) 476-4555
Entity
Organization
Contact information
Practice address
301 CEDAR ST, OROFINO, ID 83544-9029
(208) 476-4555
(208) 476-5385
Mailing address
301 CEDAR ST, OROFINO, ID 83544-9029
(208) 476-4555
(208) 476-5385
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
01
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010002830
REGENCE BLUE SHIELD GROUP
ID
05
—
805177400
—
ID
01
—
8L550
BC IDAHO GROUP PROV #
ID
Enumeration date
06/08/2007
Last updated
05/01/2008
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