| Boise Health Haus, Llc | |
|
341 E Bannock St Boise ID 83712-6208 | |
| (208) 579-5767 | |
| (208) 579-5766 |
| Full Name | Boise Health Haus, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 341 E Bannock St, Boise, Idaho |
| Authorized Official Name and Position | Molly Armijo (OWNER) |
| Authorized Official Contact | 2085795767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boise Health Haus, Llc 341 E Bannock St Boise ID 83712-6208 Ph: (208) 579-5767 | Boise Health Haus, Llc 341 E Bannock St Boise ID 83712-6208 Ph: (208) 579-5767 |
| NPI Number | 1689247611 |
|---|---|
| Provider Enumeration Date | 07/19/2021 |
| Last Update Date | 09/14/2021 |
| Medicare PECOS PAC ID | 5193121119 |
|---|---|
| Medicare Enrollment ID | O20210831000382 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689247611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Molly B Armijo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093750200 PECOS PAC ID: 9931276029 Enrollment ID: I20080915000528 |
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