OrganizationActive
Sterling Provider Group
NPI 1164044962 · Rural Health Clinic/Center · Evanston, WY
Provider details
- NPI number
- 1164044962
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Corbin Bunnage, Provider/Owner(208) 542-9111
Specialties & taxonomies
Ambulatory Health Care Facilities
- Urgent Care Clinic/Center261QU0200X
Ambulatory Health Care Facilities
- Occupational Medicine Clinic/Center261QX0100X
Ambulatory Health Care Facilities
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
Practice location
1952 Harrison Dr Ste 1
Evanston, WY 82930-3241
Phone: (208) 542-9111
Fax: (208) 542-9114
Approximate (ZIP-level) locationGet directions
Mailing address
740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Registry dates
- Enumerated
- 2020-05-14
- Last updated
- 2025-04-01
- Certified
- 2025-04-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.