Organization
TETON VALLEY HOSPITAL & SURGICENTER
Active
Other names
Teton Valley Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA C PIQUET (QUALITY SERVICES MANAGER)
(205) 354-6302
Entity
Organization
Contact information
Practice address
120 EAST HOWARD AVENUE, DRIGGS, ID 83422-5112
(208) 354-2383
(208) 354-3158
Mailing address
120 EAST HOWARD AVENUE, DRIGGS, ID 83422-5112
(208) 354-2383
(208) 354-3158
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
31
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006342
REGENCE BLUE SHIELD
ID
05
—
002279600
—
ID
01
—
00273
BLUE CROSS
ID
05
—
109085200
—
WY
05
—
4105075
—
MT
Enumeration date
02/01/2006
Last updated
02/07/2012
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