B R Boehmer Md Pa | |
1335 Albion Ave Burley ID 83318-1817 | |
(208) 878-2271 | |
Not Available |
Full Name | B R Boehmer Md Pa |
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Speciality | Clinic/Center |
Location | 1335 Albion Ave, Burley, Idaho |
Authorized Official Name and Position | Bernard R Boehmer (OWNER) |
Authorized Official Contact | 2088782271 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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B R Boehmer Md Pa 1335 Albion Ave Burley ID 83318-1817 Ph: () - | B R Boehmer Md Pa 1335 Albion Ave Burley ID 83318-1817 Ph: (208) 878-2271 |
NPI Number | 1447565627 |
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Provider Enumeration Date | 08/12/2010 |
Last Update Date | 08/12/2010 |
Medicare PECOS PAC ID | 8527182963 |
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Medicare Enrollment ID | O20100907001126 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447565627 | NPI | - | NPPES |
002799800 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | M6848 (Idaho) | Primary |
Provider Name | Bernard R Boehmer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902891484 PECOS PAC ID: 5193840544 Enrollment ID: I20100909000254 |
Provider Name | Steven Colby Boehmer |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1336563063 PECOS PAC ID: 6406162668 Enrollment ID: I20210616001557 |
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