Organization
ST. MARY'S HOSPITAL
Active
Parent organization
ST. MARY'S HOSPITAL INC
Other names
St. Mary's Clinics Midlevel Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARY'S HOSPITAL INC
Authorized official
MS. THERESA A UPTMOR (DIR OF BUSINESS SERVICES)
(208) 962-2301
Entity
Organization
Contact information
Practice address
701 LEWISTON STREET, COTTONWOOD, ID 83522-0565
(208) 962-3267
(208) 962-2313
Mailing address
PO BOX 565, COTTONWOOD, ID 83522-0565
(208) 962-3267
(208) 962-2313
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805066400
—
ID
Enumeration date
03/18/2008
Last updated
04/07/2015
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