| |
4605 Enterprise Way Ste 101 Caldwell ID 83605-8360 | |
(208) 353-7518 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 4605 Enterprise Way, Caldwell, Idaho |
Authorized Official Name and Position | Sophie Rath (MANANGER) |
Authorized Official Contact | 2087955090 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2667 E Gala Ct Ste 130 Meridian ID 83642-2788 Ph: (208) 795-5090 | 4605 Enterprise Way Ste 101 Caldwell ID 83605-8360 Ph: (208) 353-7518 |
NPI Number | 1043927882 |
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Provider Enumeration Date | 11/01/2022 |
Last Update Date | 01/16/2024 |
Medicare PECOS PAC ID | 8921441163 |
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Medicare Enrollment ID | O20240205003476 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043927882 | NPI | - | NPPES |
1295734796 | Medicaid | ID |
Provider Name | Kari M Lopez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841456191 PECOS PAC ID: 1850468208 Enrollment ID: I20080926000199 |
Provider Name | David Craig Sjostrand |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053850164 PECOS PAC ID: 2668744533 Enrollment ID: I20170828002334 |
Provider Name | Jennifer Lyn King |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477958494 PECOS PAC ID: 2668798588 Enrollment ID: I20181115000564 |
Provider Name | Tina M Bossolono-williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891264545 PECOS PAC ID: 9638418031 Enrollment ID: I20190301001302 |
Provider Name | Keira Elaine Toone |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780092130 PECOS PAC ID: 3678790540 Enrollment ID: I20240205003640 |
Alliance Medical Group, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 512 N 21st Ave, Caldwell, ID 83605 Phone: 208-985-2875 Fax: 208-985-2876 | |
Saint Alphonsus Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St, Suite 100, Caldwell, ID 83605 Phone: 208-459-7415 Fax: 208-453-3232 | |
West Valley Medical Associates Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-459-3669 Fax: 208-947-3465 | |
No8 Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 512 E Elm St, Caldwell, ID 83605 Phone: 208-370-7004 |