Healthcare Provider Details

I. General information

NPI: 1851403265
Provider Name (Legal Business Name): STEELE MEMORIAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S DAISY ST
SALMON ID
83467-0000
US

IV. Provider business mailing address

PO BOX 700
SALMON ID
83467-0700
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 TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number28
License Number StateID

VIII. Authorized Official

Name: RYAN LARSON
Title or Position: CFO
Credential:
Phone: 208-756-5561