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General NPI Number Information
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NPI Number | 1043387426
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Entity Type | Organization
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Legal Business Name | MINIDOKA MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1308 8TH ST SUITE 1
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City | RUPERT
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State | ID
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Zip | 83350-1530
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Country | US
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Telephone | 208-436-4322
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Fax | 208-434-8675
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Provider Business Mailing Address
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Address Line | 1308 8TH ST SUITE 1
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City | RUPERT
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State | ID
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Zip | 83350-1530
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Country | US
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Telephone | 208-436-4322
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Fax | 208-436-1312
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. THOMAS J MURPHY
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Credential |
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Telephone | 208-436-8141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | MMCRHC
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License Number State | ID
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