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General NPI Number Information
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NPI Number | 1730203845
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Entity Type | Organization
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Legal Business Name | EASTERN IDAHO REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 10701 S 1ST E
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7770
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Country | US
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Telephone | 208-529-9494
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Fax |
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Provider Business Mailing Address
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Address Line | 10701 S 1ST E
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City | IDAHO FALLS
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State | ID
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Zip | 83404-7770
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Country | US
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Telephone | 208-529-9494
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Fax |
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Authorized Official
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Title or Position | HYPERBARIC MEDICINE PHYSICIAN
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Name | DR. THOMAS RAY GUYER SR.
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Credential | M. D.
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Telephone | 208-529-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | ID000M3557
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License Number State | ID
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