Organization · Type 2 NPI
Shoshone Bannock Tribes, Inc
Clinic/Center · Fort Hall, ID
NPI number
1225414519
Active
Practice location
Navajo Drive Bldg 70
Fort Hall, ID 83203-0306
Fax (208) 478-4040
Mailing address
PO Box 306
Fort Hall, ID 83203-0306
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | None listed |
| Federally Qualified Health Center (FQHC) | 261QF0400X | None listed |
Clinic/Center: 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).
Another provider at this address
Other clinic/center providers in Fort Hall
About NPI 1225414519
Shoshone Bannock Tribes, Inc's National Provider Identifier is 1225414519, issued on Aug 10, 2015. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Fort Hall, ID. The record was last updated on Jan 19, 2022.