| Full Circle Health | |
|
777 N Raymond St Boise ID 83704 | |
| (208) 514-2500 | |
| (208) 375-2217 |
| Full Name | Full Circle Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 777 N Raymond St, Boise, Idaho |
| Authorized Official Name and Position | Ted D Epperly (PRESIDENT AND CEO) |
| Authorized Official Contact | 2089548744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Circle Health 777 N Raymond St Boise ID 83704-9251 Ph: (208) 514-2500 | Full Circle Health 777 N Raymond St Boise ID 83704 Ph: (208) 514-2500 |
| NPI Number | 1841490075 |
|---|---|
| Provider Enumeration Date | 07/25/2007 |
| Last Update Date | 04/15/2023 |
| Medicare PECOS PAC ID | 6709986797 |
|---|---|
| Medicare Enrollment ID | O20070703000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841490075 | NPI | - | NPPES |
| 1841490075 | Medicaid | ID | |
| 807782300 | Medicaid | ID | |
| 87843300 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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