NPIMap

Organization Active NPI

Shoshone-Bannock Community Health Center

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Fort Hall, ID
National Provider Identifier
1225570716
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
License
41257PDO Issued in ID
Legal business name
SHOSHONE-BANNOCK COMMUNITY HEALTH CENTER
Practice address
Navajo Drive BLDG 70
Fort Hall, ID 83203
Phone
(208) 478-3995
NPI assigned
Nov 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Christine Waterhouse
Title
Sbchc Director
Phone
(208) 478-3995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X 41257PDO ID Primary

Addresses

Primary practice location

Navajo Drive BLDG 70
Fort Hall, ID 83203

Mailing address

PO Box 306
Fort Hall, ID 83203-0306
Phone (208) 478-3995

Other names 1

  • Shoshone-Bannock Tribes Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shoshone Bannock Tribes Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1225570716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306",
            "city": "FORT HALL",
            "state": "ID",
            "postal_code": "832030306",
            "telephone_number": "208-478-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAJO DRIVE BLDG 70",
            "city": "FORT HALL",
            "state": "ID",
            "postal_code": "83203",
            "telephone_number": "208-478-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOSHONE-BANNOCK COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "WATERHOUSE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "SBCHC DIRECTOR",
        "authorized_official_telephone_number": "208-478-3995",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": "ID",
            "license": "41257PDO",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoshone-Bannock Tribes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Hall, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.