Organization
GRITMAN MEDICAL CENTER INC
Active
Organization
GRITMAN MEDICAL CENTER INC
Active
Other names
KENDRICK CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY JASPER (CFO)
(208) 883-2220
Entity
Organization
Contact information
Practice address
606 E MAIN ST, KENDRICK, ID 83537
(208) 289-3841
(208) 289-3961
Mailing address
700 S MAIN ST, MOSCOW, ID 83843
(208) 882-4511
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
39
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138308
REGENCE
ID
05
—
7118532
—
WA
05
—
805890000
—
ID
01
—
8A612
BLUE CROSS
ID
Enumeration date
10/03/2006
Last updated
02/14/2017
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