Advanced Vein Therapy

LBN: Gem State Radiology Llp
Advanced Vein Therapy is an health care organization with primary practice located at 927 W Myrtle St Ste B , Boise ID 83702-7061. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is the primary health care specialty. Gem State Radiology Llp can be contacted via phone (208) 947-0100, or through Baldwin, Wayne via phone (208) 384-9060.

Contact Information

Primary practice address
927 W Myrtle St Ste B Boise ID 83702-7061
Phone: (208) 947-0100
Fax: (208) 384-9023
Website:
Map and Directions
Authorized official contact:
Name: Baldwin, Wayne
Phone: (208) 384-9060

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X

Profile Details

NPI number 1124258611
LBN Legal business name Gem State Radiology Llp
DBA Doing business as Advanced Vein Therapy
Authorized official Baldwin, Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Jul 20th, 2009
Last updated Oct 31st, 2023 - about last year

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 1124258611 NPPES
Idaho MEDICAID 805368800

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