OrganizationActive
Southfork Healthcare
NPI 1134462856 · Primary Care Clinic/Center · Swan Valley, ID
Provider details
- NPI number
- 1134462856
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Wendy Swope, Administrator(208) 360-1997
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
166 Elk Path
Swan Valley, ID 83449-0101
Phone: (208) 360-1997
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 101
Swan Valley, ID 83449-0101
Registry dates
- Enumerated
- 2013-04-01
- Last updated
- 2023-05-29
- Certified
- 2023-05-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.