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Organization

ST. MARY'S HOSPITAL

Active
Other names
St. Mary's Grangeville Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE M GATES (DIRECTOR OF REVENUE CYCLE)
(208) 476-8083
Entity
Organization

Contact information

Practice address
617 W NORTH ST, GRANGEVILLE, ID 83530-1239
(208) 962-3267
(208) 962-2313
Mailing address
617 W NORTH ST, GRANGEVILLE, ID 83530-1239
(208) 962-3267
(208) 962-2313

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ID
363LF0000X
Family Nurse Practitioner
ID

Other

Enumeration date
04/08/2010
Last updated
10/02/2020
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