Organization Name: | WALTER KNOX MEMORIAL HOSPITAL |
NPI Number: | 1295193423 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BECKY MALAXECHEBARRIA (BUSINESS OFFICE MANAGER) |
Mailing Address: | 119 N Wardwell Ave Emmett |
State: | ID US |
Postal Code: | 836173040 |
Phone Number: | 2083656311 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2016 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |