Fall River Medical, Pllc
LBN: Fall River Medical, Pllc
Fall River Medical, Pllc is an health care organization with primary practice located at 21 Winn Dr , Rexburg ID 83440. The organization recently has 5 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Clinic/Center, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Research, Ambulatory Health Care Facilities / Urgent Care, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Fall River Medical, Pllc can be contacted via phone (208) 881-5222, or through Gillette, Austin C via phone (208) 881-5222.
Contact Information
Primary practice address
21 Winn Dr
Rexburg ID 83440
Phone: (208) 881-5222
Fax: (877) 441-4715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Clinic/Center | 261Q00000X | O-0518 | Idaho |
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | O-0518 | Idaho |
| Ambulatory Health Care Facilities / Research | 261QR1100X | O-0518 | Idaho |
| Ambulatory Health Care Facilities / Urgent Care | 261QU0200X | O-0518 | Idaho |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1457698987 |
|---|---|
| LBN Legal business name | Fall River Medical, Pllc |
| DBA Doing business as | |
| Authorized official | Gillette, Austin C Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 3rd, 2013 |
| Last updated | Nov 19th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457698987 | NPPES |
| Idaho | Other | 1083810287 | NPI |
| Idaho | Other | 1972709103 | NPI |
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