TRI-STATE MEMORIAL HOSPITAL (NPI# 1386690907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386690907 |
| Entity Type | Organization |
| Organization Name | TRI-STATE MEMORIAL HOSPITAL |
| Other Organization Name | TRI STATE DIALYSIS CENTER |
| Practice Address |
730 21st St Lewiston ID 83501-3323 |
| Mailing Address |
1221 Highland Ave. Po Box 189 Clarkston WA 98940 |
| Practice Telephone | 2087468280 |
| Practice Fax Number | 2087468285 |
| Mailing Telephone | 5097585511 |
| Mailing Fax Number | 5097519406 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-08-04 |
| Authorized Official Name | MR. ALEX C. TOWN (CFO) |
| Authorized Official Telephone | 5097584667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities | ||
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
H-108 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 3308004 | 05 | |
| ID | 003110900 | 05 |
| Other Name | Type Code |
|---|---|
| Tri State Dialysis Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174697353 | Tri-state Memorial Hospital | Medicare Defined Swing Bed Unit | 1221 Highland Avenue, Clarkston, WA 99403 | 2006-11-20 |
| 1831100254 | Tri-state Memorial Hospital | Hospice Care, Community Based | 1100 Highland Avenue, Clarkston, WA 99403 | 2006-08-10 |
| 1760485221 | Tri-state Memorial Hospital | General Acute Care Hospital | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2005-05-27 |
| 1932405693 | Tri-state Memorial Hospital | Internal Medicine | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2011-01-28 |
| 1598814352 | Tri-state Memorial Hospital | Family Medicine | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2007-01-10 |
| 1124135215 | Tri-state Memorial Hospital | Home Health | 1100 Highland Avenue, Clarkston, WA 99403 | 2006-08-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | TRI-STATE MEMORIAL HOSPITAL | 1221 Highland Ave, Clarkston, WA 99403-2829 |
| Street Address |
730 21ST ST |
| City | LEWISTON |
| State | ID |
| Zip Code | 83501-3323 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
| 1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
| 1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
| 1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
| 1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
| 1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
| 1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
| 1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
| 1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
| 1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
| Find all providers in zip 83501 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457749475 | Lewis-clark Kidney Center LLC | Clinic/Center | 2116 12th Ave, Lewiston, ID 83501-3502 | 2014-12-29 |
| 1437573995 | Lewis Clark Kidney Center LLC | Clinic/Center | 222 Southway Ave Ste A, Lewiston, ID 83501-2703 | 2014-02-04 |
| 1790701779 | Bio-medical Applications of Maine, Inc. | Clinic/Center | 710 Main St, Lewiston, ME 04240-5801 | 2006-07-14 |
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| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1740708965 | Total Renal Care Inc | Clinic/Center | 1070 N Curtis Rd Ste 125, Boise, ID 83706 | 2017-09-08 |
| 1083146559 | Total Renal Care, Inc. | Clinic/Center | 815 Nw 13th St, Fruitland, ID 83619 | 2017-04-03 |
| 1144621665 | Dsi Post Falls, LLC | Clinic/Center | 920 N Highway 41, Suite 3-6, Post Falls, ID 83854-8806 | 2014-09-16 |
| 1427472141 | Boise Dialysis Partners II, LLC | Clinic/Center | 1109 W Myrtle St Ste 120, Boise, ID 83702-6971 | 2014-02-17 |
| 1467883967 | Dsi Kellogg, LLC | Clinic/Center | 858 Commerce Dr., Smelterville, ID 83868 | 2013-12-09 |
| 1154669695 | Tfld Partners, LLC | Clinic/Center | 350 North Haven Drive, Twin Falls, ID 83301 | 2013-01-17 |
| 1255643243 | Ldcd LLC | Clinic/Center | 4620 Enterprise Way, Suite 101, Caldwell, ID 83605-6764 | 2010-07-08 |
| 1225265606 | Total Renal Care Inc | Clinic/Center | 212 Rodeo Dr Ste 110, Moscow, ID 83843-9791 | 2009-06-12 |
| Find all providers with the same taxonomy | ||||
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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.