| Organization Name: | LOST RIVERS DISTRICT HOSPITAL |
| NPI Number: | 1427062181 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRAD HUERTA (CEO) |
| Mailing Address: | 551 1/2 Highland Dr Arco |
| State: | ID US |
| Postal Code: | 83213 |
| Phone Number: | 2085278206 |
| Fax Number: | 2085273616 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 03/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 170100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Medical Genetics, Ph.D. Medical Genetics |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |