| |
204 Triangle Dr, Ponderay, ID 83852-9729 | |
(208) 255-1640 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Home Health |
Location | 204 Triangle Dr, Ponderay, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346898830 | NPI | - | NPPES |
13-7122 | Other | ID | PTAN |
1346898830 | Medicaid | ID | |
HH-247 | Other | ID | HOME HEALTH AGENCY LICENSE |
Mailing Address | Practice Location Address |
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4601 Ne 77th Ave Ste 300, Vancouver, WA 98662-6736 Ph: (360) 892-6628 | 204 Triangle Dr, Ponderay, ID 83852-9729 Ph: (208) 255-1640 |