Healthcare Provider Details

I. General information

NPI: 1598763849
Provider Name (Legal Business Name): POWER COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 TYHEE AVE
AMERICAN FALLS ID
83211-1224
US

IV. Provider business mailing address

510 ROOSEVELT ST
AMERICAN FALLS ID
83211-1362
US

V. Phone/Fax

Practice location:
  • Phone: 208-226-3200
  • Fax: 208-226-3223
Mailing address:
  • Phone: 208-226-3200
  • Fax: 208-226-3223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: KLISTA BRITTON-MAHAN
Title or Position: REVENUE CYCLE SPECIALIST
Credential:
Phone: 208-226-3200