Organization · Type 2 NPI

North Canyon Medical Center, Inc

Rural Health Clinic/Center · Jerome, ID

NPI number 1376160457 Active

Practice location

491 Heritage Dr
Jerome, ID 83338-6701

Call (208) 644-7500 Map

Fax (208) 644-7501

Mailing address

267 N Canyon Dr
Gooding, ID 83330-5500

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

Another provider at this address

Logan Reed Jones, DOFamily Medicine Physician Jerome, ID NPI 1710540885

NPI record

NPI: 1376160457
Entity type: Organization (Type 2)
Issued: Jul 6, 2020
Last updated: Jan 29, 2021
Status: Active
Subpart: Yes of North Canyon Medical Center, Inc.

Other names

<unavail>
North Canyon Jerome Clinic · doing business as
North Canyon Jerome Clinic · doing business as

Authorized official

Sara Demoe
CFO
(208) 934-9695

Verify this record

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 1376160457

North Canyon Medical Center, Inc's National Provider Identifier is 1376160457, issued on Jul 6, 2020. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Jerome, ID. The record was last updated on Jan 29, 2021.