Payette Lakes Medical Clinic, Pa

LBN: Payette Lakes Medical Clinic, Pa
Payette Lakes Medical Clinic, Pa is an health care organization with primary practice located at 211 Forest Street , Mccall ID 83638. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Payette Lakes Medical Clinic, Pa can be contacted via phone (208) 634-2225, or through Bruns, Jacqueline R. via phone (208) 634-4061.

Contact Information

Primary practice address
211 Forest Street Mccall ID 83638
Phone: (208) 634-2225
Fax: (208) 634-7212
Website:
Map and Directions
Authorized official contact:
Name: Bruns, Jacqueline R.
Phone: (208) 634-4061

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1255462263
LBN Legal business name Payette Lakes Medical Clinic, Pa
DBA Doing business as
Authorized official Bruns, Jacqueline R.
Entity Organization
Organization subpart 1 No
Enumeration date Mar 8th, 2007
Last updated Mar 11th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255462263 NPPES
Idaho Other 8934-2 BLUE CROSS
Idaho Other 000010006343 BLUE CROSS

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