Shoshone-Bannock Community Health Center
LBN: Shoshone Bannock Tribes, Inc
Shoshone-Bannock Community Health Center is an health care organization with primary practice located at Navajo Drive Bldg 70 , Fort Hall ID 83203-0306. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Clinic/Center is the primary health care specialty.
Shoshone Bannock Tribes, Inc can be contacted via phone (208) 478-3995, or through Johnson, Melissa M via phone (517) 896-3464.
Contact Information
Primary practice address
Navajo Drive Bldg 70
Fort Hall ID 83203-0306
Phone: (208) 478-3995
Fax: (208) 478-4040
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1225414519 |
|---|---|
| LBN Legal business name | Shoshone Bannock Tribes, Inc |
| DBA Doing business as | Shoshone-Bannock Community Health Center |
| Authorized official | Johnson, Melissa M |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 10th, 2015 |
| Last updated | Jan 19th, 2022 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225414519 | NPPES |
| Idaho | MEDICAID | 1225414519 |
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