Idaho Orthopedic & Sports Clinic Pa

LBN: Idaho Orthopedic & Sports Clinic Pa
Idaho Orthopedic & Sports Clinic Pa is an health care organization with primary practice located at 560 Memorial Dr , Pocatello ID 83201-4073. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Idaho Orthopedic & Sports Clinic Pa can be contacted via phone (208) 234-1969, or through Hall, Ryan via phone (208) 234-1960.

Contact Information

Primary practice address
560 Memorial Dr Pocatello ID 83201-4073
Phone: (208) 234-1969
Fax: (208) 233-5033
Website:
Map and Directions
Authorized official contact:
Name: Hall, Ryan
Phone: (208) 234-1960

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1538238571
LBN Legal business name Idaho Orthopedic & Sports Clinic Pa
DBA Doing business as
Authorized official Hall, Ryan
Entity Organization
Organization subpart 1 No
Enumeration date Nov 6th, 2006
Last updated Jul 30th, 2015 - about 10 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 1538238571 NPPES
Idaho MEDICAID 805136500

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