Organization
BINGHAM MEMORIAL HOSPITAL
Active
Other names
Bingham Memorial Extended Care Facility
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS KRAML (CEO)
(208) 785-3804
Entity
Organization
Contact information
Practice address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4101
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4101
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
H36
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002854700
—
ID
01
—
01073
BLUE CROSS PROVIDER #
ID
Enumeration date
01/20/2006
Last updated
12/16/2019
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