Organization
ELMORE MEDICAL CENTER HOSPITAL DISTRICT
Active
Other names
Trinity Mountain Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREG MAUER (CEO)
(208) 580-2677
Entity
Organization
Contact information
Practice address
465 MCKENNA DR, MOUNTAIN HOME, ID 83647-2143
(208) 587-9703
(208) 580-9812
Mailing address
465 MCKENNA DR, MOUNTAIN HOME, ID 83647-2143
(208) 587-9703
(208) 580-9812
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/18/2006
Last updated
08/22/2020
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