BEAR LAKE MEMORIAL HOSPITAL (NPI# 1740598614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740598614 |
| Entity Type | Organization |
| Organization Name | BEAR LAKE MEMORIAL HOSPITAL |
| Other Organization Name | BEAR LAKE MANOR |
| Practice Address |
855 Boise St Montpelier ID 83254-1070 |
| Practice Telephone | 2088472400 |
| Mailing Telephone | 2088472400 |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2010-09-14 |
| Authorized Official Name | RYAN MESSERLY (PFS DIRECTOR) |
| Authorized Official Telephone | 2088470920 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | RC-738 | ID | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 806513000 | 05 |
| Other Name | Type Code |
|---|---|
| Bear Lake Manor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639399793 | Bear Lake Memorial Hospital | General Acute Care Hospital | 164 S 5th St, Montpelier, ID 83254-1557 | 2007-04-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEAR LAKE MEMORIAL HOSPITAL | 164 S 5th St, Montpelier, ID 83254-1557 |
| Street Address |
855 BOISE ST |
| City | MONTPELIER |
| State | ID |
| Zip Code | 83254-1070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366597866 | Joseph F Decker Professional Corp | Surgery | 164 S 5th, Montpelier, ID 83254 | 2007-01-24 |
| 1447311139 | Bear Lake County | Ambulance | 385 Cemetary Road, Montpelier, ID 83254 | 2006-12-13 |
| 1073685343 | Steven D Hammond | Dentist | 455 Washington St, Montpelier, ID 83254 | 2006-11-14 |
| 1982610549 | Dorian S Grunig | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-08-01 |
| 1104840412 | Harold A Olson | Pharmacist | 765 Washington St., Montpelier, ID 83254 | 2006-07-27 |
| 1033603345 | Sydnie M Hobbs | Nurse Practitioner | 152 S 4th St, Montpelier, ID 83254 | 2018-06-20 |
| 1265505705 | Robert D Degnan | Obstetrics & Gynecology | 742 Washington St, Montpelier, ID 83254 | 2006-11-15 |
| 1952491714 | Gary Scott Griffin | Nurse Anesthetist, Certified Registered | 164 South 5th, Montpelier, ID 83254 | 2006-10-13 |
| 1013027952 | Matthew Brinton Stevens | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| 1265542435 | Reset P.a. | Chiropractor | 710 N 4th St, Montpelier, ID 83254-1050 | 2006-08-30 |
| Find all providers in zip 83254 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407462906 | Etosha Assisted Living, Inc | Assisted Living Facility | 243 N 300 E, Rupert, ID 83350-9491 | 2020-09-20 |
| 1548886963 | Diamond View Care Properties, LLC | Assisted Living Facility | 3570 E Amity Rd, Meridian, ID 83642-7014 | 2020-06-22 |
| 1619593068 | Frontier Management, LLC | Assisted Living Facility | 10250 W Smoke Ranch Dr, Boise, ID 83709-1467 | 2020-06-22 |
| 1174149991 | Rsl Renaissance, LLC | Assisted Living Facility | 2772 W Avante Loop, Coeur D Alene, ID 83815-0333 | 2020-06-17 |
| 1891319141 | Grace At Caldwell LLC | Assisted Living Facility | 518 N 21st Ave, Caldwell, ID 83605-4368 | 2020-06-02 |
| 1790309045 | Grace At Fairview Lakes LLC | Assisted Living Facility | 1960 N Lakes Pl, Meridian, ID 83646-5939 | 2020-06-02 |
| 1164046413 | Grace Memory Care At State Street LLC | Assisted Living Facility | 9779 W State St, Boise, ID 83714-1638 | 2020-06-02 |
| 1356965693 | Grace At State Street LLC | Assisted Living Facility | 9995 W State St, Boise, ID 83714-1636 | 2020-06-02 |
| 1336763689 | Grace LLC | Assisted Living Facility | 1610 Sunnyridge Rd, Nampa, ID 83686-7401 | 2020-06-02 |
| 1447874797 | Grace At Englefield Green LLC | Assisted Living Facility | 250 S Allumbaugh Way, Boise, ID 83709-5624 | 2020-06-02 |
| Find all providers with the same taxonomy | ||||
| City | MONTPELIER |
| Zip Code | 83254 |
Please comment or provide details below to improve the information on BEAR LAKE MEMORIAL HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.