Organization
GLENNS FERRY HEALTH CENTER INC
Active
Other names
Xray EKG, Desert Sage Health Centers
Organization subpart
No
Provider details
NPI number
Authorized official
SHARLET WILSON (EXECUTIVE ASSISTANT)
(208) 696-7203
Entity
Organization
Contact information
Practice address
486 W 1ST AVE, GLENNS FERRY, ID 83623-2701
(208) 366-7416
(208) 366-2595
Mailing address
120 DESERT SAGE WAY, MOUNTAIN HOME, ID 83647-1038
(208) 696-7203
(208) 587-3324
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002550200
—
ID
Enumeration date
05/31/2007
Last updated
09/20/2024
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