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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