Shoshone Bannock Tribes, Inc
Shoshone Bannock Tribes, Inc is a Clinic/Center in Fort Hall, Idaho. Registered with an NPI since 2015.
- In the registry since
- 2015
- Specialties on file
- 2
What do these letters mean?
- Inc — Incorporated
- A form of business registration, not a clinical qualification.
Practice location Address checks out
Navajo Dr Bldg 70Fort Hall, ID 83203-0306
Phone: (208) 478-3995
Fax: (208) 478-4040
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinic/Center (primary) | Taxonomy 261Q00000X |
|---|---|
| Federally Qualified Health Center (FQHC) | Taxonomy 261QF0400X |
Record details
| NPI number | 1225414519 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Melissa Johnson — Credentialing Manager · (517) 896-3464 |
| Other names | Shoshone-Bannock Community Health Center |
| NPI enumerated | August 10, 2015 |
| Last updated in NPPES | January 19, 2022 |
| Certification date | January 19, 2022 |
| Mailing address | Po Box 306, Fort Hall, ID 83203-0306 |
Other providers in Fort Hall
-
Shoshone Bannock Tribes, Inc
717 Mission Rd, Fort Hall, ID 83203-0306 · (208) 238-2400