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General NPI Number Information
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NPI Number | 1184752347
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Entity Type | Organization
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Legal Business Name | CARIBOU MEDICAL CENTER, INC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 300 S 3RD W
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City | SODA SPRINGS
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State | ID
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Zip | 83276-1559
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Country | US
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Telephone | 208-547-3341
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Fax | 208-547-2790
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Provider Business Mailing Address
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Address Line | 300 S 3RD W
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City | SODA SPRINGS
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State | ID
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Zip | 83276-1559
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Country | US
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Telephone | 208-547-3341
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Fax | 208-547-2790
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Authorized Official
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Title or Position | CEO
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Name | CHRISTINA THOMAS
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Credential |
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Telephone | 208-547-2765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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