Boise Skin Clinic Pllc

LBN: Boise Skin Clinic Pllc
Boise Skin Clinic Pllc is an health care organization with primary practice located at 1636 S Hadley Ave , Boise ID 83709-2684. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Boise Skin Clinic Pllc can be contacted via phone (208) 209-7898, or through Ririe, Marnie R via phone (208) 258-2078.

Contact Information

Primary practice address
1636 S Hadley Ave Boise ID 83709-2684
Phone: (208) 209-7898
Fax: (208) 258-2079
Website:
Map and Directions
Authorized official contact:
Name: Ririe, Marnie R Doctor of Medicine (MD)
Phone: (208) 258-2078

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X M-9342 Idaho

Profile Details

NPI number 1104220797
LBN Legal business name Boise Skin Clinic Pllc
DBA Doing business as
Authorized official Ririe, Marnie R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 10th, 2014
Last updated Jan 22nd, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104220797 NPPES
Idaho MEDICAID 1134170855

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