Healthcare Provider Details

I. General information

NPI: 1144516717
Provider Name (Legal Business Name): WEISER VALLEY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 E LIBERTY ST
WEISER ID
83672-2261
US

IV. Provider business mailing address

645 E 5TH ST
WEISER ID
83672-2202
US

V. Phone/Fax

Practice location:
  • Phone: 208-414-1124
  • Fax: 208-414-0947
Mailing address:
  • Phone: 208-549-0370
  • Fax: 208-414-4267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number32
License Number StateID

VIII. Authorized Official

Name: PAM STAMPFLI
Title or Position: CFO
Credential:
Phone: 208-549-0370