Gem State Dermatology, Pa
LBN: Gem State Dermatology, Pa
Gem State Dermatology, Pa is an health care organization with primary practice located at 388 E. Parkcenter Blvd. , Boise ID 83706. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Ambulatory Health Care Facilities / Medical Specialty, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Gem State Dermatology, Pa can be contacted via phone (208) 424-9101, or through Morgan, Michelle via phone (208) 424-9101.
Contact Information
Primary practice address
388 E. Parkcenter Blvd.
Boise ID 83706
Phone: (208) 424-9101
Fax: (208) 424-5072
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | M7247 | Idaho |
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | M7247 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA377 | Idaho |
Profile Details
| NPI number | 1912040270 |
|---|---|
| LBN Legal business name | Gem State Dermatology, Pa |
| DBA Doing business as | |
| Authorized official | Morgan, Michelle |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Dec 2nd, 2014 - about 11 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 | 1912040270 | NPPES |
| Idaho | MEDICAID | 805054600 |
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