Advanced Vein Therapy
LBN: Gem State Radiology Llp
Advanced Vein Therapy is an health care organization with primary practice located at 161 E Mallard Dr Suite 130, Boise ID 83706-3974. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty.
Gem State Radiology Llp can be contacted via phone (208) 384-9060, or through Cliff, Jeffrey R via phone (208) 384-9060.
Contact Information
Primary practice address
161 E Mallard Dr Suite 130
Boise ID 83706-3974
Phone: (208) 384-9060
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ||
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X |
Profile Details
| NPI number | 1154584712 |
|---|---|
| LBN Legal business name | Gem State Radiology Llp |
| DBA Doing business as | Advanced Vein Therapy |
| Authorized official | Cliff, Jeffrey R |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jul 3rd, 2008 |
| Last updated | Jul 3rd, 2008 - about 16 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 | 1154584712 | NPPES |
| Idaho | MEDICAID | 002874800 |
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