GRITMAN MEDICAL CENTER INC (NPI# 1356438816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356438816 |
| Entity Type | Organization |
| Organization Name | GRITMAN MEDICAL CENTER INC |
| Other Organization Name | POTLATCH CLINIC |
| Practice Address |
156 6th St Potlatch ID 83855 |
| Mailing Address |
700 S Main St Moscow ID 83843 |
| Practice Telephone | 2088752380 |
| Practice Fax Number | 2088752303 |
| Mailing Telephone | 2088824511 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2017-02-14 |
| Authorized Official Name | MRS. KARA L BESST (CEO) |
| Authorized Official Telephone | 2088832220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
39 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 805681000 | 05 | |
| ID | BLUE CROSS | 8A612 | 01 |
| WA | 7095847 | 05 | |
| ID | REGENCE | 000010138303 | 01 |
| Other Name | Type Code |
|---|---|
| POTLATCH CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871708289 | Gritman Medical Center Inc | Day Training, Developmentally Disabled Services | 324 S Cleveland St, Moscow, ID 83843-3768 | 2007-05-11 |
| 1013556596 | Gritman Medical Center Inc | Pain Medicine | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2019-12-31 |
| 1932769700 | Gritman Medical Center Inc | Internal Medicine | 700 S Main St, Moscow, ID 83843-3046 | 2019-06-14 |
| 1235626474 | Gritman Medical Center Inc | Psychiatry & Neurology | 803 S Main St Ste 210, Moscow, ID 83843-2695 | 2018-04-13 |
| 1235680703 | Gritman Medical Center Inc | Internal Medicine | 804 S Washington St Ste A, Moscow, ID 83843-3182 | 2016-10-20 |
| 1477004828 | Gritman Medical Center Inc | General Practice | 412 S Main St, Troy, ID 83871 | 2016-10-20 |
| 1386041119 | Gritman Medical Center Inc | Skilled Nursing Facility | 700 S Main St, Moscow, ID 83843-3056 | 2014-11-21 |
| 1942567847 | Gritman Medical Center Inc | Physician Assistant | 412 S Main St, Troy, ID 83871-0415 | 2012-04-16 |
| 1750475380 | Gritman Medical Center Inc | Clinic/Center | 606 E Main St, Kendrick, ID 83537 | 2006-10-03 |
| 1619988144 | Gritman Medical Center Inc | General Acute Care Hospital | 700 S Main St, Moscow, ID 83843-3056 | 2006-08-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | GRITMAN MEDICAL CENTER INC. | 700 S Main St, Moscow, ID 83843 |
| Street Address |
156 6TH ST |
| City | POTLATCH |
| State | ID |
| Zip Code | 83855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992091722 | Skyler S Worthington | Physician Assistant | 156 6th St, Potlatch, ID 83855 | 2011-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043854508 | Allison Lea Zimms | Massage Therapist | 635 Larch Street, Potlatch, ID 83855 | 2019-10-28 |
| 1558817494 | Suzanne Paul | Family Medicine | 325 Larch Street, Potlatch, ID 83855 | 2016-08-31 |
| 1245515832 | Potlatch Family Dental, PC | Dentist | 225 6th Street, Potlatch, ID 83855 | 2011-10-15 |
| 1053504829 | Potlatch Rural Fire Dist | Ambulance | 512 Pine Street, Potlatch, ID 83855 | 2007-08-24 |
| 1285776112 | County of Latah 285 School District | Local Education Agency (LEA) | 136th Street, Potlatch, ID 83855 | 2007-02-14 |
| 1962573444 | Michael S. Hess | Pharmacist | 525 Pine St, Potlatch, ID 83855 | 2006-11-13 |
| 1689661050 | Charlotte S Ainge | Physician Assistant | 156 N. 6th St, Potlatch, ID 83855 | 2005-09-30 |
| 1669866612 | Dan Lawson Dds, PC | Dentist | 225 6th Street, Potlatch, ID 83855 | 2015-03-26 |
| 1982955779 | Jennifer L Davis | Physician Assistant | 225 6th St, Potlatch, ID 83855 | 2012-09-20 |
| 1407410517 | Nicholas John Browneller | Specialist | 610 Oak St, Potlatch, ID 83855-0359 | 2019-04-24 |
| Find all providers in zip 83855 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1023271731 | Upper Valley Family Medicine Rhc | Clinic/Center | 530 Rigby Lake Dr, Rigby, ID 83442-1271 | 2008-07-03 |
| 1891984167 | Bmh Inc | Clinic/Center | 1425 Parkway Drive, Blackfoot, ID 83221-1758 | 2007-10-23 |
| 1043387426 | Minidoka Memorial Hospital | Clinic/Center | 1308 8th St, Suite 1, Rupert, ID 83350-1530 | 2006-11-29 |
| 1245267467 | Hti Physican Services of Utah,inc | Clinic/Center | 124 5th Street, Suite A, Wilder, ID 83676-0037 | 2006-06-26 |
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| 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.