Organization
HEALTH WEST, INC.
Active
Parent organization
HEALTH WEST, INC.
Other names
HEALTH WEST DOWNEY CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEALTH WEST, INC.
Authorized official
MINDY BENEDETTI (CEO)
(208) 232-7862
Entity
Organization
Contact information
Practice address
79 N MAIN ST, DOWNEY, ID 83234
(208) 897-5600
(208) 897-5603
Mailing address
PO BOX 2377, POCATELLO, ID 83206-2377
(208) 232-7862
(208) 232-7869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M7806
ID
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002446000
—
ID
01
—
85910
BLUE CROSS OF IDAHO
ID
Enumeration date
08/15/2005
Last updated
08/17/2020
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