MEDICARE: MOUNTAIN VIEW HOSPITAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician
2	207RP1001X	Pulmonary Disease Physician
3	261QR1300X	Rural Health Clinic/Center
4	282N00000X	General Acute Care Hospital	64	ID

General Provider Information

NPI Number	:	1669462362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN VIEW HOSPITAL LLC

Provider Business Mailing Address
First Line	:	2325 CORONADO ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-7407
Country	:	US
Telephone Number	:	208-557-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2325 CORONADO ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-7407
Country	:	US
Telephone Number	:	208-557-2700
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAMES G ADAMSON
Credential	:
Telephone Number	:	208-557-2728

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	05/21/2024

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Directions to “MOUNTAIN VIEW HOSPITAL LLC ” Practice Location

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