Provider Demographics
NPI:1093810442
Name:POWER COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:POWER COUNTY HOSPITAL DISTRICT
Other - Org Name:HARMS SWINGBED
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PATIENT ACCOUNTING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-226-3200
Mailing Address - Street 1:510 ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FLS
Mailing Address - State:ID
Mailing Address - Zip Code:83211-1362
Mailing Address - Country:US
Mailing Address - Phone:208-226-3200
Mailing Address - Fax:208-226-3223
Practice Address - Street 1:510 ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:AMERICAN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83211-1362
Practice Address - Country:US
Practice Address - Phone:208-226-3200
Practice Address - Fax:208-226-3223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID25275N00000X
282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807468800Medicaid
ID13Z304Medicare Oscar/Certification