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Shoshone Bannock Tribes, Inc
Clinic/Center in Fort Hall, Idaho
NPI 1801949763

Shoshone Bannock Tribes, Inc is a Clinic/Center based in Fort Hall, ID. Shoshone Bannock Tribes, Inc practices in Fort Hall, ID. The NPI Number for Shoshone Bannock Tribes, Inc is 1801949763 and holds a License No. (Idaho).

The current practice location address for Shoshone Bannock Tribes, Inc is 717 Mission Road, Fort Hall, ID and can be reached out via phone at 208-238-2400 and via fax at 208-238-5462.

Location: 717 Mission Road, Fort Hall, ID, 83203-0306
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1801949763
Provider Name
Shoshone Bannock Tribes, Inc
Credential
Provider Entity Type
Organization
Address
717 Mission Road, Fort Hall, ID, 83203-0306
Phone Number
208-238-2400
Fax Number
208-238-5462
Provider Enumeration Date
01/22/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
002264100 05 ID
003399100 05 ID
8063500 05 ID
8064977 05 ID
806648600 05 ID
80662922 05 ID
institution
Provider Business Practice Location Address Details
Address
717 Mission Road
City
Fort Hall
State
Idaho
Zip
83203-0306
Phone Number
208-238-2400
Fax Number
208-238-5462
person
Provider Business Mailing Address Details
Address
717 Mission Road
City
Fort Hall
State
Idaho
Zip
83203-0306
Phone Number
208-238-2400
Fax Number
208-238-5462
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).
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