Organization
BMH INC
Active
Parent organization
BMH INC.
Other names
Physicians and Surgeons of Shelley
Organization subpart
Yes
Provider details
NPI number
Legal business name
BMH INC.
Authorized official
MR. JACOB ERICKSON (CEO)
(208) 785-3801
Entity
Organization
Contact information
Practice address
275 W LOCUST ST, SHELLEY, ID 83274-1230
(208) 782-2960
Mailing address
275 W LOCUST ST, SHELLEY, ID 83274-1230
(208) 782-2960
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
36
ID
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010137702
BLUE SHIELD OF IDAHO
ID
05
—
807947000
—
ID
01
—
8N304
BLUE CROSS OF IDAHO
ID
Enumeration date
10/09/2007
Last updated
02/11/2021
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