Organization
CARIBOU MEMORIAL HOSPITAL
Active
Parent organization
CARIBOU MEMORIAL HOSPITAL AND LIVING CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARIBOU MEMORIAL HOSPITAL AND LIVING CENTER
Authorized official
JOHN HOOPES (CHIEF EXECUTIVE OFFICE)
(208) 547-3341
Entity
Organization
Contact information
Practice address
300 S 3RD W, SODA SPRINGS, ID 83276-1559
(208) 547-3341
(208) 547-2790
Mailing address
300 S 3RD W, SODA SPRINGS, ID 83276-1559
(208) 547-3341
(208) 547-2790
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
37
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00042
BLUE CROSS OF IDAHO
ID
05
—
002863100
—
ID
05
—
002863200
—
ID
05
—
002863500
—
ID
01
—
86934
BLUE CROSS PHYSICIAN
ID
Enumeration date
11/03/2005
Last updated
08/09/2013
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