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General NPI Number Information
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NPI Number | 1255281911
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Entity Type | Organization
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Legal Business Name | ST. MARY'S HOSPITAL & CLINICS, INC.
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 429 MAIN ST
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City | COTTONWOOD
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State | ID
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Zip | 83522-5270
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Country | US
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Telephone | 208-962-3401
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Fax | 208-962-5150
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Provider Business Mailing Address
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Address Line | 429 MAIN ST
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City | COTTONWOOD
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State | ID
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Zip | 83522-5270
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Country | US
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Telephone | 208-962-3401
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Fax | 208-962-5150
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Authorized Official
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Title or Position | CEO
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Name | LENNE BONNER
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Credential |
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Telephone | 208-476-4555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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