Healthcare Provider Details

I. General information

NPI: 1992913479
Provider Name (Legal Business Name): STEELE MEMORIAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S. DAISY ST.
SALMON ID
83467
US

IV. Provider business mailing address

203 S. DAISY ST.
SALMON ID
83467
US

V. Phone/Fax

Practice location:
  • Phone: 208-756-5600
  • Fax: 208-756-4169
Mailing address:
  • Phone: 208-756-5600
  • Fax: 208-756-4169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number28
License Number StateID

VIII. Authorized Official

Name: ABNER KING
Title or Position: COO
Credential:
Phone: 208-756-5720