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General NPI Number Information
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NPI Number | 1073562591
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Entity Type | Organization
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Legal Business Name | BONNER GENERAL HOSPITAL, INC.
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 520 N 3RD AVE
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City | SANDPOINT
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State | ID
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Zip | 83864-1507
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Country | US
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Telephone | 208-265-1179
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Fax | 208-265-1085
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Provider Business Mailing Address
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Address Line | PO BOX 1353
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City | SANDPOINT
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State | ID
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Zip | 83864-0863
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Country | US
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Telephone | 208-265-1179
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Fax | 208-265-1085
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER BONNER GENE
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Name | JOHN HENNESSY
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Credential |
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Telephone | 208-263-1441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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