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NPI Code Detail

MEDICARE: ST. BENEDICTS FAMILY MEDICAL CENTER

MEDICARE: ST. BENEDICTS FAMILY MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282E00000XLong Term Care Hospital366HPID

General Provider Information

NPI Number : 1639211634
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. BENEDICTS FAMILY MEDICAL CENTER
Provider Business Mailing Address
First Line : 709 N LINCOLN AVE
Second Line :
City : JEROME
State : ID
Zip : 83338-1851
Country : US
Telephone Number : 208-324-4301
Fax Number : 208-324-7815
Provider Business Practice Location Address
First Line : 709 N LINCOLN AVE
Second Line :
City : JEROME
State : ID
Zip : 83338-1851
Country : US
Telephone Number : 208-324-4301
Fax Number : 208-324-7815
Authorized Official
Title or Position : PHARMACY DIRECTOR
Name : MR. BRUCE ALAN BARNES
Credential : RPH
Telephone Number : 208-324-4301
Provider Enumeration Date : 02/13/2007
Last Update Date : 08/22/2020

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Directions to “ST. BENEDICTS FAMILY MEDICAL CENTER ” Practice Location

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