NPI 1649759374

North Canyon Mountain Home Clinic

Organisation Clinic/Center Mountain Home, ID

Practice location

Address: 840 N 4th E, Mountain Home, ID 83647-2166
Phone: (208) 934-8829
Fax: (208) 934-4874
Mailing address: 267 N Canyon Dr, Gooding, ID 83330-5500

Authorised official

Name: Tim Powers
Title: Ceo
Phone: (208) 934-8765

Registered specialties

Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261Q00000X

Other Clinic/Center providers in Idaho →

Registry record

NPI: 1649759374
Entity type: Organization
NPI issued: 13 Aug 2018
Record last updated: 13 Aug 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.