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General NPI Number Information
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NPI Number | 1619988144
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Entity Type | Organization
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Legal Business Name | GRITMAN MEDICAL CENTER INC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 700 S MAIN ST
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City | MOSCOW
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State | ID
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Zip | 83843-3056
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Country | US
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Telephone | 208-882-4511
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Fax | 208-883-6580
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Provider Business Mailing Address
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Address Line | 700 S MAIN ST
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City | MOSCOW
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State | ID
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Zip | 83843-3056
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Country | US
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Telephone | 208-882-4511
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Fax | 208-883-6580
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Authorized Official
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Title or Position | PRESIDENT/ CEO
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Name | MRS. KARA L BESST
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Credential |
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Telephone | 208-883-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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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 | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 39
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License Number State | ID
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