Organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Active
Parent organization
BEAR LAKE COUNTY MEMORIAL ANESTHESIA
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEAR LAKE COUNTY MEMORIAL ANESTHESIA
Authorized official
MRS. LAURIE BINGHAM (CREDENTIALING SPECIALISTS)
(208) 847-4327
Entity
Organization
Contact information
Practice address
164 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-4327
(208) 847-4334
Mailing address
164 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-4327
(208) 847-4334
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
35
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002852800
—
ID
Enumeration date
04/23/2007
Last updated
08/04/2011
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