Organization
GRITMAN MEDICAL CENTER INC
Active
Other names
POTLATCH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KARA L BESST (CEO)
(208) 883-2220
Entity
Organization
Contact information
Practice address
156 6TH ST, POTLATCH, ID 83855
(208) 875-2380
(208) 875-2303
Mailing address
700 S MAIN ST, MOSCOW, ID 83843
(208) 882-4511
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
39
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138303
REGENCE
ID
05
—
7095847
—
WA
05
—
805681000
—
ID
01
—
8A612
BLUE CROSS
ID
Enumeration date
10/06/2006
Last updated
02/14/2017
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