Pathology Associates Of Idaho Falls P A

LBN: Pathology Associates Of Idaho Falls P A
Pathology Associates Of Idaho Falls P A is an health care organization with primary practice located at 3100 Channing Way , Idaho Falls ID 83404-7533. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as the primary health care specialty. Pathology Associates Of Idaho Falls P A can be contacted via phone (208) 529-6050, or through Tannenbaum, Matt via phone (208) 529-6050.

Contact Information

Primary practice address
3100 Channing Way Idaho Falls ID 83404-7533
Phone: (208) 529-6050
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Tannenbaum, Matt Doctor of Medicine (MD)
Phone: (208) 529-6050

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X

Profile Details

NPI number 1497723241
LBN Legal business name Pathology Associates Of Idaho Falls P A
DBA Doing business as
Authorized official Tannenbaum, Matt Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 9th, 2006
Last updated Mar 6th, 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 1497723241 NPPES
Idaho MEDICAID 002346700
Idaho Other 88971
Idaho Other 000010026929

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