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Contact Information

SHOSHONE BANNOCK TRIBES
717 MISSION ROAD
FORT HALL, ID83203
 Phone: 208-238-5421
 Fax: 208-238-5462
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for SHOSHONE BANNOCK TRIBES

NPI Number 1952518946
LBN Legal business name SHOSHONE BANNOCK TRIBES
Authorized official ANGELA MENDEZ - (TRIBAL HEALTH DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/17/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
ID Medicaid 8066486
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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