Organization
MINIDOKA MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J MURPHY (ADMINISTRATOR)
(208) 436-8141
Entity
Organization
Contact information
Practice address
1224 8TH ST, RUPERT, ID 83350-1527
(208) 436-0481
(208) 434-8675
Mailing address
1224 8TH ST, RUPERT, ID 83350-1527
(208) 436-0481
(208) 436-6038
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
26
ID
282NC0060X
Critical Access Hospital
Primary
26
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006548
BLUE SHIELD
ID
01
—
00166
BLUE CROSS
ID
01
—
1254303
CIGNA GOVERNMENT SERVICES
—
05
—
M0023360
—
ID
Enumeration date
01/18/2006
Last updated
03/26/2025
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