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Organization

NORTH CANYON MEDICAL CENTER, INC.

Active
Parent organization
NORTH CANYON MEDICAL CENTER, INC.
Other names
Medicare Diabetic Prevention Program
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTH CANYON MEDICAL CENTER, INC.
Authorized official
TIMOTHY L POWERS (CHIEF EXECUTIVE OFFICER)
(208) 934-8765
Entity
Organization

Contact information

Practice address
267 N CANYON DR, GOODING, ID 83330-5500
(208) 934-9886
(208) 735-3718
Mailing address
267 N CANYON DR, GOODING, ID 83330-5500
(208) 934-9886
(208) 735-3718

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
ID

Other

Enumeration date
06/06/2018
Last updated
06/06/2018
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