Provider Demographics
NPI:1548355811
Name:FRANKLIN COUNTY MEDICAL CENTER
Entity type:Organization
Organization Name:FRANKLIN COUNTY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-852-0137
Mailing Address - Street 1:44 N 1ST E
Mailing Address - Street 2:
Mailing Address - City:PRESTON
Mailing Address - State:ID
Mailing Address - Zip Code:83263-1326
Mailing Address - Country:US
Mailing Address - Phone:208-852-0137
Mailing Address - Fax:208-852-3812
Practice Address - Street 1:44 N 1ST E
Practice Address - Street 2:
Practice Address - City:PRESTON
Practice Address - State:ID
Practice Address - Zip Code:83263
Practice Address - Country:US
Practice Address - Phone:208-852-0137
Practice Address - Fax:208-852-3812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010006660OtherBLUE SHIELD IP/OP
IDD02859600Medicaid
ID002859700Medicaid
ID002860600Medicaid
ID000010006659OtherBLUE SHIELD PHYSICIAN
ID002860200Medicaid
ID00422OtherBLUE-X IP/OP
ID8L170OtherBLUE-X PHYSICIAN
ID8L170OtherBLUE-X PHYSICIAN
ID137058Medicare ID - Type UnspecifiedHOME HEALTH