Organization
BMH, INC.
Active
Other names
Cedar Creek Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB ERICKSON (CEO)
(208) 785-3801
Entity
Organization
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 782-3700
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 782-3700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002854200
—
ID
01
—
8L618
BLUE CROSS GRP OLD
ID
01
—
8N216
BLUE CROSS GRP
ID
Enumeration date
06/27/2007
Last updated
12/18/2019
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