Organization
ELMORE MEDICAL CENTER HOSPITAL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA SENGER (CFO)
(208) 587-8401
Entity
Organization
Contact information
Practice address
895 NORTH 6TH EAST, MOUNTAIN HOME, ID 83647
(208) 587-8401
(208) 587-8406
Mailing address
895 NORTH 6TH EAST, MOUNTAIN HOME, ID 83647
(208) 587-8401
(208) 587-8406
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010148578
BLUE SHIELD
ID
01
—
000010149755
BLUE SHIELD PROF NUMBER
ID
05
—
002860700
—
ID
01
—
00406
BLUE CROSS
ID
01
—
13Z311
MEDICARE SWING BED
ID
01
—
807044000
MEDICAID PROFESSIONAL FEE
ID
01
—
8K594
BLUE CROSS PROF NUMBER
ID
Enumeration date
06/17/2005
Last updated
07/21/2022
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