Provider Demographics
NPI:1720298102
Name:WEISER VALLEY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:WEISER VALLEY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMPFLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-549-0370
Mailing Address - Street 1:645 E. 5TH STREET
Mailing Address - Street 2:
Mailing Address - City:WEISER
Mailing Address - State:ID
Mailing Address - Zip Code:83672-2202
Mailing Address - Country:US
Mailing Address - Phone:208-549-0370
Mailing Address - Fax:208-414-4267
Practice Address - Street 1:645 E. 5TH STREET
Practice Address - Street 2:
Practice Address - City:WEISER
Practice Address - State:ID
Practice Address - Zip Code:83672-2202
Practice Address - Country:US
Practice Address - Phone:208-549-0370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID32282NC0060X
275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002850400Medicaid
ID002851300Medicaid
ID806996800Medicaid
ID002852000Medicaid
ID002850300Medicaid
OR121244Medicaid
WA3032901Medicaid
ID002850300Medicaid