Prestige Ketamine Pc

LBN: Prestige Ketamine Pc
Prestige Ketamine Pc is an health care organization with primary practice located at 3749 E 343 N , Rigby ID 83442-5326. The organization recently has only one registered license in Ambulatory Health Care Facilities / Infusion Therapy, which is considered as the primary health care specialty. Prestige Ketamine Pc can be contacted via phone (208) 705-9800, or through Hansen, Levi via phone (208) 705-9800.

Contact Information

Primary practice address
3749 E 343 N Rigby ID 83442-5326
Phone: (208) 705-9800
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hansen, Levi
Phone: (208) 705-9800

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Infusion Therapy 261QI0500X

Profile Details

NPI number 1588353999
LBN Legal business name Prestige Ketamine Pc
DBA Doing business as
Authorized official Hansen, Levi
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2023
Last updated May 2nd, 2023 - about 2 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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