Provider Demographics
NPI:1194844068
Name:POWER COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:POWER COUNTY HOSPITAL DISTRICT
Other - Org Name:HARMS MEMORIAL HOSPITAL DISTRICT (RX)
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 FALLS
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:2007-03-29
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID25282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002814400Medicaid