Organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Active
Parent organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Other names
Bear Lake County Memorial Home Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Authorized official
MRS. SHAUNA DAWES (DIRECTOR OF HOME HEALTH)
(208) 847-4454
Entity
Organization
Contact information
Practice address
164 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-4454
(208) 847-4414
Mailing address
164 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-4454
(208) 847-4414
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HH107
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002853200
—
ID
Enumeration date
01/09/2007
Last updated
07/14/2015
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