Organization
NORTH CANYON MEDICAL CENTER INC.
Active
Other names
North Canyon Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
SARA DEMOE (CONTROLLER)
(208) 934-9695
Entity
Organization
Contact information
Practice address
267 NORTH CANYON DRIVE, GOODING, ID 83330-1858
(208) 934-4433
(208) 934-8643
Mailing address
267 NORTH CANYON DRIVE, GOODING, ID 83330
(208) 934-4433
(208) 934-8643
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
19
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010166495
REGENCE BLUE SHIELD
ID
01
—
000010166504
REGENCE BLUE SHIELD EMERENCY ROOM
ID
05
—
002856400
—
ID
01
—
1252103
CIGNA GOVERNMENT
TN
01
—
1285925602
JENNIFER OLSEN
ID
01
—
131302
MEDICARE
ID
01
—
1518377019
GOODING FAMILY PHYSICIANS
ID
01
—
1609046671
NORTH CANYON MEDICAL CENTER
ID
01
—
185627500
DEPT OF LABOR
—
01
—
1952716540
JENNIFER PARSONS
ID
01
—
614134000
DEPARTMENT OF LABOR
ID
01
—
805657700
MEDICAID LIFELINE
ID
01
—
805694900
MEDICAID EMERGENCY ROOM
ID
05
—
808314000
—
ID
Enumeration date
03/06/2008
Last updated
03/02/2022
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