Childrens Kidney Specialists Pllc

LBN: Childrens Kidney Specialists Pllc
Childrens Kidney Specialists Pllc is an health care organization with primary practice located at 100 E Idaho St 200, Boise ID 83712-6223. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Nephrology, which is considered as the primary health care specialty. Childrens Kidney Specialists Pllc can be contacted via phone (208) 381-7336, or through Jenkins, Randall via phone (208) 381-7336.

Contact Information

Primary practice address
100 E Idaho St 200 Boise ID 83712-6223
Phone: (208) 381-7336
Fax: (208) 381-7495
Website:
Map and Directions
Authorized official contact:
Name: Jenkins, Randall Doctor of Medicine (MD)
Phone: (208) 381-7336

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X M6943 Idaho

Profile Details

NPI number 1700088002
LBN Legal business name Childrens Kidney Specialists Pllc
DBA Doing business as
Authorized official Jenkins, Randall Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2007
Last updated Jun 20th, 2012 - about 13 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 1700088002 NPPES
Idaho Other 000010026970 BLUE SHIELD
Idaho MEDICAID 003401500 BLUE SHIELD

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