Organization
STEELE MEMORIAL MEDICAL CENTER
Active
Organization
STEELE MEMORIAL MEDICAL CENTER
Active
Other names
Steele Memorial Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN LARSON (CFO)
(208) 756-5616
Entity
Organization
Contact information
Practice address
805 MAIN ST, SALMON, ID 83467-4316
(208) 756-6212
(208) 756-6336
Mailing address
PO BOX 700, SALMON, ID 83467-0700
(208) 756-5698
(208) 756-5826
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00356
CLINIC-BLUE CROSS
ID
05
—
1254505
—
ID
01
—
133996
MEDICAID-CLINIC
ID
01
—
8D145
BLUE CROSS
ID
Enumeration date
11/01/2022
Last updated
11/01/2022
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