Root Cause Integrative Medicine Llc

LBN: Root Cause Integrative Medicine Llc
Root Cause Integrative Medicine Llc is an health care organization with primary practice located at 1547 S Midway Ave Suite B, Ammon ID 83406. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Root Cause Integrative Medicine Llc can be contacted via phone (208) 497-0429, or through Hale, Jordan Neil via phone (650) 933-6384.

Contact Information

Primary practice address
1547 S Midway Ave Suite B Ammon ID 83406
Phone: (208) 497-0429
Fax: (208) 497-0430
Website:
Map and Directions
Authorized official contact:
Name: Hale, Jordan Neil Physician's Assistant Certified (PA-C)
Phone: (650) 933-6384

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1447718853
LBN Legal business name Root Cause Integrative Medicine Llc
DBA Doing business as
Authorized official Hale, Jordan Neil Physician's Assistant Certified (PA-C)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 5th, 2019
Last updated Apr 10th, 2019 - about 6 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 1447718853 NPPES
Idaho MEDICAID 1396110169

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