Organization · Type 2 NPI

Bear Lake Community Health Center, Inc.

Federally Qualified Health Center (FQHC) · Montpelier, ID

NPI number 1003264664 Active

Practice location

152 S 4th St
Montpelier, ID 83254-1538

Call (208) 847-2108 Map

Fax (208) 847-2109

Mailing address

517 W 100 N Ste 210
Providence, UT 84332-9826

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

7 other providers at this address

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NPI record

NPI: 1003264664
Entity type: Organization (Type 2)
Issued: May 24, 2016
Last updated: Jun 1, 2022
Status: Active

Other names

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Bear Lake Community Health Center-Montpelier · doing business as
Bear Lake Community Health Center-Montpelier · doing business as

Authorized official

Jorge Garcia
CEO
(435) 755-6061

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003264664

Bear Lake Community Health Center, Inc.'s National Provider Identifier is 1003264664, issued on May 24, 2016. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Montpelier, ID. The record was last updated on Jun 1, 2022.