Not Tsoo Gah Nee

Organization Active NPI Federal Public Health Clinic/Center · Ft Hall, ID

NPI 1366801458 · NPPES record last updated Feb 17, 2016

Key facts

NPI
1366801458
Entity type
Organization (NPI type 2)
Primary specialty
Federal Public Health Clinic/Center 261QP0904X
License
PN-15140 (ID)
Legal business name
NOT TSOO GAH NEE
Practice address
717 Mission Rd
Ft Hall, ID 83203
Phone
(208) 238-5427
NPI assigned
Feb 17, 2016
Organization subpart
No

Authorized official

Name
Ms. Kellie Ann Alcorn, LPN
Title
LPN
Phone
(208) 238-5427

Corporate family (same tax ID) 5

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

National Provider Directory

Tax ID family
Not-Tsoo Gah-Nee Indian Health Center (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X PN-15140 ID Yes

Addresses

Primary practice location

717 Mission Rd
Ft Hall, ID 83203

Mailing address

PO Box 717 Mission Rd
Ft Hall, ID 83203
Phone (208) 238-5427

Other identifiers

IdentifierTypeStateIssuer
003398900MedicaidID

Other providers in Ft Hall, ID

All providers in Ft Hall, ID · Federal Public Health Clinic/Center in Idaho

Sources for this page

Verify at the official NPI Registry.