Victor Medical Clinic
LBN: Teton Valley Hosital & Surgicenter
Victor Medical Clinic is an health care organization with primary practice located at 252 South Main Street , Victor ID 83455. The organization recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Teton Valley Hosital & Surgicenter can be contacted via phone (208) 354-6307, or through Piquet, Laura C via phone (208) 354-6302.
Contact Information
Primary practice address
252 South Main Street
Victor ID 83455
Phone: (208) 354-6307
Fax: (208) 787-7456
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 31 | Idaho |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 31 | Idaho |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 31 | Idaho |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 31 | Idaho |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 31 | Idaho |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 31 | Idaho |
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 31 | Idaho |
Profile Details
| NPI number | 1881734135 |
|---|---|
| LBN Legal business name | Teton Valley Hosital & Surgicenter |
| DBA Doing business as | Victor Medical Clinic |
| Authorized official | Piquet, Laura C |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Feb 7th, 2007 |
| Last updated | Nov 18th, 2010 - about 16 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 | 1881734135 | NPPES |
| Idaho | Other | 000010031568 | REGENCE BLUE SHIELD |
| Idaho | MEDICAID | 807736300 | REGENCE BLUE SHIELD |
| Idaho | Other | 8M954 | REGENCE BLUE SHIELD |
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