| Bhg Medical Services - Idaho | |
|
92 S Cole Rd Obot Room #100 Boise ID 83709-0930 | |
| (208) 376-5021 | |
| (208) 376-5020 |
| Full Name | Bhg Medical Services - Idaho |
|---|---|
| Speciality | Clinic/Center |
| Location | 92 S Cole Rd, Boise, Idaho |
| Authorized Official Name and Position | Zack Ragsdale (DIRECTOR) |
| Authorized Official Contact | 5124545911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhg Medical Services - Idaho 5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 Ph: (214) 365-6100 | Bhg Medical Services - Idaho 92 S Cole Rd Obot Room #100 Boise ID 83709-0930 Ph: (208) 376-5021 |
| NPI Number | 1194435123 |
|---|---|
| Provider Enumeration Date | 11/30/2022 |
| Last Update Date | 09/23/2024 |
| Certification Date | 09/23/2024 |
| Medicare PECOS PAC ID | 6204299936 |
|---|---|
| Medicare Enrollment ID | O20230829002579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194435123 | NPI | - | NPPES |
| Provider Name | Cynthia Diane Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710564125 PECOS PAC ID: 5496164303 Enrollment ID: I20230830000830 |
| Provider Name | Vincent Marchese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831847383 PECOS PAC ID: 9436507563 Enrollment ID: I20231129002054 |
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