Idaho Falls Clinic, P.A.

LBN: Idaho Falls Clinic, P.A.
Idaho Falls Clinic, P.A. is an health care organization with primary practice located at 2001 S Woodruff Ave Suite #15, Idaho Falls ID 83404-6374. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Idaho Falls Clinic, P.A. can be contacted via phone (208) 522-7310, or through Clark, Christine C. via phone (208) 522-7310.

Contact Information

Primary practice address
2001 S Woodruff Ave Suite #15 Idaho Falls ID 83404-6374
Phone: (208) 522-7310
Fax: (208) 524-0559
Website:
Map and Directions
Authorized official contact:
Name: Clark, Christine C.
Phone: (208) 522-7310

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1811932411
LBN Legal business name Idaho Falls Clinic, P.A.
DBA Doing business as
Authorized official Clark, Christine C.
Entity Organization
Organization subpart 1 No
Enumeration date Jun 18th, 2006
Last updated Aug 22nd, 2020 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1811932411 NPPES
Idaho Other P9154 RR MEDICARE
Idaho Other I843154 RR MEDICARE
Idaho Other 88468 RR MEDICARE

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