KEITH E DAVIS; NPI #1972673218

Contact Information

KEITH E DAVIS

113 S APPLE ST
SHOSHONE, ID 83352-5287

Phone: 208-886-2222
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for KEITH E DAVIS

NPI # 1972673218

LBN Legal business name KEITH E DAVIS

Authorized official KEITH DAVIS - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/08/2006

Last updated 03/08/2012 - About 14 years ago

Identifiers

Medicaid

806290300

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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