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Shoshone Bannock Tribes, Inc
Federally Qualified Health Center (FQHC) in Fort Hall, Idaho
NPI 1225414519

Shoshone Bannock Tribes, Inc is a Federally Qualified Health Center (FQHC) based in Fort Hall, ID and is specialized in Federally Qualified Health Center (FQHC). Shoshone Bannock Tribes, Inc practices in Fort Hall, ID. The NPI Number for Shoshone Bannock Tribes, Inc is 1225414519 and holds a License No. (Idaho).

The current practice location address for Shoshone Bannock Tribes, Inc is Navajo Drive Bldg 70, Fort Hall, ID and can be reached out via phone at 208-478-3995 and via fax at 208-478-4040.

Location: Navajo Drive Bldg 70, Fort Hall, ID, 83203-0306
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1225414519
Provider Name
Shoshone Bannock Tribes, Inc
Credential
Provider Entity Type
Organization
Address
Navajo Drive Bldg 70, Fort Hall, ID, 83203-0306
Phone Number
208-478-3995
Fax Number
208-478-4040
Provider Enumeration Date
08/10/2015
Last Update Date
03/13/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1225414519 05 ID
institution
Provider Business Practice Location Address Details
Address
Navajo Drive Bldg 70
City
Fort Hall
State
Idaho
Zip
83203-0306
Phone Number
208-478-3995
Fax Number
208-478-4040
person
Provider Business Mailing Address Details
Address
Navajo Drive Bldg 70
City
Fort Hall
State
Idaho
Zip
83203-0306
Phone Number
208-478-3995
Fax Number
208-478-4040
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
261QF0400X
License No.
()
Definition
Definition to come...
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