| NPI | 1801949763 |
|---|---|
| Doing Business As | SHOSHONE BANNOCK CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANGELA MENDEZ Tribal Health Director 208-478-3744 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2010-01-25 |