National Provider Identifier Database

MCCALL MEMORIAL HOSPITAL
Critical Access Hospital

An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified.


Contact Information

MCCALL MEMORIAL HOSPITAL
1010 STATE STREET
MCCALL, ID83638-3704
Phone: 208-634-2221
Fax: 208-634-7112
Website:
Specialty Taxonomy Code
* Critical Access Hospital 261QC0050X

* Indicates primary specialty

NPI Profile & details for MCCALL MEMORIAL HOSPITAL

NPI Number 1265442388
Legal business name
LBN
MCCALL MEMORIAL HOSPITAL
Authorized official MATT GROENIG - (VP FINANCE)
Entity Organization
Organization subpart Yes
Enumeration date 08/09/2006
Last updated 05/06/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: 11
  • ID Medicaid: 806937700
  • ID Medicaid: 807424900
  • ID Other: 8J612 BLUE CROSS CLINIC GRP #
  • ID Other: 000010147637 REGENCE CLINIC GRP #

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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