Organization
KOOTENAI HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON NESS (CEO)
(208) 625-5081
Entity
Organization
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
42
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010004925
REGENCE BLUE SHIELD
ID
05
—
002292400
—
ID
01
—
00257
BLUE CROSS
ID
Enumeration date
01/09/2007
Last updated
01/05/2024
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