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Organization

NORTH GEM SCHOOL DISTRICT #149

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROBIN CORDER (MEDICAID CLERK)
(208) 604-1557
Entity
Organization

Contact information

Practice address
360 SOUTH MAIN ST, BANCROFT, ID 83217-0000
(208) 648-7848
(208) 648-7895
Mailing address
360 SOUTH MAIN ST, BANCROFT, ID 83217-0000
(208) 648-7848
(208) 648-7895

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
ID

Other

Enumeration date
08/28/2013
Last updated
08/28/2013
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