Healthcare Provider Details

I. General information

NPI: 1306883244
Provider Name (Legal Business Name): BOUNDARY REGIONAL COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6615 COMANCHE ST
BONNERS FERRY ID
83805
US

IV. Provider business mailing address

PO BOX 2160
SANDPOINT ID
83864-0908
US

V. Phone/Fax

Practice location:
  • Phone: 208-267-1718
  • Fax: 208-267-7739
Mailing address:
  • Phone: 208-263-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: KEVIN KNEPPER
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 208-263-3410