Provider Demographics
NPI:1205720232
Name:GRITMAN MEDICAL CENTER INC
Entity type:Organization
Organization Name:GRITMAN MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BESST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-883-2220
Mailing Address - Street 1:PO BOX 8007
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-0507
Mailing Address - Country:US
Mailing Address - Phone:208-882-8812
Mailing Address - Fax:208-892-3714
Practice Address - Street 1:719 S MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-3041
Practice Address - Country:US
Practice Address - Phone:208-882-3092
Practice Address - Fax:208-883-6550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRITMAN MEDICAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy