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General NPI Number Information
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NPI Number | 1255449013
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Entity Type | Organization
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Legal Business Name | CLEARWATER VALLEY HOSPITAL & CLINICS INC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 301 CEDAR ST
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City | OROFINO
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State | ID
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Zip | 83544-9029
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Country | US
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Telephone | 208-476-4555
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Fax | 208-476-5385
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Provider Business Mailing Address
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Address Line | 301 CEDAR ST
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City | OROFINO
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State | ID
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Zip | 83544-9029
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Country | US
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Telephone | 208-476-4555
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Fax | 208-476-5385
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MRS. LENNE J BONNER
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Credential |
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Telephone | 208-476-8008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number |
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License Number State | ID
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