| Caring Edge Op Llc | |
|
77 N Fisher Park Way Eagle ID 83616 | |
| (208) 473-2717 | |
| (877) 890-5617 |
| Full Name | Caring Edge Op Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 77 N Fisher Park Way, Eagle, Idaho |
| Authorized Official Name and Position | Christopher Lougheed (PROVIDER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2088669001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caring Edge Op Llc 2965 E Tarpon Dr Ste 150 Meridian ID 83642-9007 Ph: (208) 287-9420 | Caring Edge Op Llc 77 N Fisher Park Way Eagle ID 83616 Ph: (208) 473-2717 |
| NPI Number | 1700399359 |
|---|---|
| Provider Enumeration Date | 11/06/2017 |
| Last Update Date | 09/05/2018 |
| Medicare PECOS PAC ID | 6406114131 |
|---|---|
| Medicare Enrollment ID | O20171229000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700399359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Allison Andrews Boldridge |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023273331 PECOS PAC ID: 4789926544 Enrollment ID: I20190425002597 |
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