MINIDOKA MEMORIAL HOSPITAL


Address: 1308 8th St, Suite 1, Rupert, ID 83350-1530
Phone: 2084364322

MINIDOKA MEMORIAL HOSPITAL (NPI# 1043387426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043387426
Entity Type Organization
Organization Name MINIDOKA MEMORIAL HOSPITAL
Other Organization Name MINIDOKA MEDICAL CENTER
Practice Address 1308 8th St
Suite 1
Rupert
ID 83350-1530
Practice Telephone 2084364322
Practice Fax Number 2084361312
Mailing Telephone 2084364322
Mailing Fax Number 2084361312
Enumeration Date 2006-11-29
Last Update Date 2016-01-18
Authorized Official Name MR. THOMAS J MURPHY (ADMINISTRATOR)
Authorized Official Telephone 2084368141
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR1300X Clinic/Center
Specialization: Rural Health
MMCRHC ID Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
ID BLUE CROSS 74146 01
ID M8073867 05
ID BLUE SHIELD 00001002451 01

Other Provider/Organization Names

Other Name Type Code
Minidoka Medical Center Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1134333495 Minidoka Memorial Hospital Clinic/Center 1224 8th St, Rupert, ID 83350-1527 2007-05-09
1942364070 Minidoka Memorial Hospital Pharmacy 1224 8th St, Rupert, ID 83350-1527 2006-12-21
1023052040 Minidoka Memorial Hospital Skilled Nursing Facility 1224 8th St, Rupert, ID 83350-1527 2006-06-16
1205870219 Minidoka Memorial Hospital Home Health 1224 8th St, Rupert, ID 83350-1527 2006-06-16
1679553531 Minidoka Memorial Hospital Medicare Defined Swing Bed Unit 1224 8th St, Rupert, ID 83350-1527 2006-01-18

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities MINIDOKA MEMORIAL HOSPITAL 1224 8th St, Rupert, ID 83350-1527

Office Location

Street Address 1308 8TH ST
SUITE 1
City RUPERT
State ID
Zip Code 83350-1530

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205312774 Shawna M Mccaffrey Nurse Practitioner 1308 8th St, Rupert, ID 83350 2018-07-17
1851635114 Casie Taylor Nurse Practitioner 1308 8th St, Ste 1, Rupert, ID 83350-1535 2012-11-26

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417349515 Robbie Joe Carroll Registered Nurse 1024 8th Street, Family Health Services, Rupert, ID 83350 2015-02-26
1285921643 Duane Broderick Counselor 2311 Parke Ave., Ste. 8, Burley, ID 83350 2011-07-06
1598798282 Kerry W Saurey Family Medicine 1218 9th St, Ste 7, Rupert, ID 83350 2006-07-08
1093761694 Family Health Services Corporation Dental Hygienist 402 6th St, Rupert, ID 83350 2006-05-25
1376531004 Jeffrey Scott Swenson Family Medicine 1308 8th St Ste 1, Rupert, ID 83350 2005-10-06
1386872810 Brian R Muir Family Medicine 1308 8th St Ste 1, Rupert, ID 83350 2009-06-23
1083816334 Cameron Mchan Nurse Practitioner 1308 8th St Ste 1, Rupert, ID 83350 2007-05-31
1134225956 Margo Saunders Specialist 1308 8th St Ste 1, Rupert, ID 83350 2006-09-16
1619900305 Don C Pates Family Medicine 1218 9th St, Ste 7, Rupert, ID 83350 2006-07-08
1740680404 Peggy Goodman Physical Therapist 610 18th St, Rupert, ID 83350-1027 2014-09-01
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Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

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Competitor

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City RUPERT
Zip Code 83350

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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