MEDICARE: TETON VALLEY HOSPITAL & SURGICENTER

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
1	207X00000X	Orthopaedic Surgery Physician	31	ID
2	208000000X	Pediatrics Physician	31	ID
3	208VP0014X	Interventional Pain Medicine Physician	31	ID
4	208600000X	Surgery Physician	31	ID
5	208800000X	Urology Physician	31	ID
6	1041C0700X	Clinical Social Worker	31	ID
7	207Q00000X	Family Medicine Physician	31	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000010159438	OTHER	ID	REGENCE BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8M953	OTHER	ID	BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780625632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TETON VALLEY HOSPITAL & SURGICENTER

Provider Business Mailing Address
First Line	:	120 EAST HOWARD AVENUE
Second Line	:
City	:	DRIGGS
State	:	ID
Zip	:	83422-5112
Country	:	US
Telephone Number	:	208-354-2302
Fax Number	:	208-354-8392

Provider Business Practice Location Address
First Line	:	283 N 1ST STREET
Second Line	:
City	:	DRIGGS
State	:	ID
Zip	:	83422-5112
Country	:	US
Telephone Number	:	208-354-2302
Fax Number	:	208-354-8392

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MRS. LAURA C PIQUET
Credential	:
Telephone Number	:	208-354-6302

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	10/29/2012

Similar Medicare Providers

1396715371 — TROY D WESTON PA
Practice Location Address:

120 E HOWARD ST , TETON VALLEY HEALTH CARE
DRIGGS, ID
83422-5112

Practice Phone: 208-354-6302
Practice Fax: 208-354-3158

1710959184 — TETON VALLEY HOSPITAL & SURGICENTER
Practice Location Address:

120 EAST HOWARD AVENUE
DRIGGS, ID
83422-5112

Practice Phone: 208-354-2383
Practice Fax: 208-354-3158

1821031998 — MR. DAVID A SAURMAN PA-C
Practice Location Address:

120 EAST HOWARD AVENUE , TETON VALLEY HEALTH CARE
DRIGGS, ID
83422-5112

Practice Phone: 208-354-6302
Practice Fax: 208-354-3158

1770504391 — TETON VALLEY HOSPITAL & SURGICENTER
Practice Location Address:

120 E HOWARD ST
DRIGGS, ID
83422-5112

Practice Phone: 208-354-6317
Practice Fax:

1417015876 — TERRELL L. KELLY LCSW
Practice Location Address:

120 E HOWARD ST
DRIGGS, ID
83422-5112

Practice Phone: 208-354-6317
Practice Fax:

1053525964 — MRS. ROSE MARIE RAUBE P.T.A
Practice Location Address:

120 E HOWARD ST
DRIGGS, ID
83422-5112

Practice Phone: 208-354-3128
Practice Fax:

Directions to “TETON VALLEY HOSPITAL & SURGICENTER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.