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General NPI Number Information
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NPI Number | 1265442388
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Entity Type | Organization
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Legal Business Name | MCCALL MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 1010 STATE STREET
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City | MCCALL
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State | ID
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Zip | 83638-3704
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Country | US
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Telephone | 208-634-2221
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Fax | 208-634-7112
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Provider Business Mailing Address
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Address Line | 1000 STATE ST
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City | MCCALL
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State | ID
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Zip | 83638-3704
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Country | US
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Telephone | 208-634-2221
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Fax | 208-634-7112
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Authorized Official
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Title or Position | VP FINANCE
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Name | MR. MATT GROENIG
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Credential |
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Telephone | 208-634-2221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC0050X
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Taxonomy Name | Critical Access Hospital Clinic/Center
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License Number | 11
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License Number State | ID
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