Evergreen Physical Medicine

LBN: Evergreen Physical Medicine, Llc
Evergreen Physical Medicine is an health care organization with primary practice located at 1710 W Cherry Ln , Meridian ID 83642-1340. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as the primary health care specialty. Evergreen Physical Medicine, Llc can be contacted via phone (208) 895-8595, or through Dance, Summer via phone (208) 895-8595.

Contact Information

Primary practice address
1710 W Cherry Ln Meridian ID 83642-1340
Phone: (208) 895-8595
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Dance, Summer
Phone: (208) 895-8595

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1538668421
LBN Legal business name Evergreen Physical Medicine, Llc
DBA Doing business as Evergreen Physical Medicine
Authorized official Dance, Summer
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2018
Last updated Feb 6th, 2018 - about 7 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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