| Cache Clinic | |
|
30 E Little Ave Driggs ID 83422-5138 | |
| (208) 354-6302 | |
| (208) 354-3158 |
| Full Name | Cache Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 30 E Little Ave, Driggs, Idaho |
| Authorized Official Name and Position | Laura C Piquet (DIRECTOR OF COMPLIANCE) |
| Authorized Official Contact | 2083546302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cache Clinic 120 E Howard St Driggs ID 83422-5112 Ph: (208) 354-6302 | Cache Clinic 30 E Little Ave Driggs ID 83422-5138 Ph: (208) 354-6302 |
| NPI Number | 1417405606 |
|---|---|
| Provider Enumeration Date | 09/15/2016 |
| Last Update Date | 09/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417405606 | NPI | - | NPPES |
| 6 | Other | RETAIL CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 31 (Idaho) | Primary |
| 363AM0700X | Physician Assistant - Medical | 31 (Idaho) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 31 (Idaho) | Secondary |
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