Organization
CARIBOU MEDICAL CENTER, INC
Active
Other names
Caribou Medical Center, Caribou Medical Center Professional
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA THOMAS (CEO)
(208) 547-2765
Entity
Organization
Contact information
Practice address
300 S 3RD W, SODA SPRINGS, ID 83276-1559
(208) 547-3341
(208) 547-2790
Mailing address
300 S 3RD W, SODA SPRINGS, ID 83276-1559
(208) 547-3341
(208) 547-2790
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002863200
—
ID
Enumeration date
12/12/2006
Last updated
02/08/2022
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