| Organization Name: | MEMORIAL HOSPITAL - ER PHYSICIANS |
| NPI Number: | 1720282866 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WADE JOHNSON (CEO) |
| Mailing Address: | 645 E 5th St Weiser |
| State: | ID US |
| Postal Code: | 836722202 |
| Phone Number: | 2085490370 |
| Fax Number: | 2084144267 |
| NPI Enumeration Date: | 06/13/2007 |
| NPI Last Update Date: | 01/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 32 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |