OrganizationActive
Snake River Pediatrics, PC
NPI 1720489396 · Rural Health Clinic/Center · Fruitland, ID
Provider details
- NPI number
- 1720489396
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Matthew Berria, President
- License
- PA00913 (OR)
Practice location
1100 Nw 12th St
Fruitland, ID 83619-5040
Phone: (208) 452-6556
Fax: (541) 216-6557
Mailing address
1100 Nw 12th St
Fruitland, ID 83619-5040
Registry dates
- Enumerated
- 2014-09-14
- Last updated
- 2023-08-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.