PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC; NPI #1205104593

Contact Information

PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC

1420 S BLAINE ST STE 5
MOSCOW, ID 83843-3973

Phone: 208-882-2247
Fax: 509-336-7482
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Rural Health	261QR1300X	B4[14]	Rural Health Clinic
Pediatrics	208000000X	37	Physician/Pediatric Medicine
Psychiatry	2084P0800X	26	Physician/Psychiatry

Indicates primary specialty

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NPI Profile & details for PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC

NPI # 1205104593

LBN Legal business name PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC

Authorized official GROVER 'PETE' PETERS - (CLINIC ADMINISTRATOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/01/2011

Last updated 06/26/2015 - About 11 years ago

Identifiers

ID	License #	13-3860
ID	Other	13-3860	CMS CERTIFICATION
ID	Other	1369068	MEDICARE PTAN

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC

Contact Information

Specialty

Rural Health

Pediatrics

Psychiatry

NPI Profile & details for PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC

Reviews for PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC