Grand Peaks Medical | |
72 S 1st E Ste 101 Rexburg ID 83440-1902 | |
(208) 356-4900 | |
(208) 356-3724 |
Full Name | Grand Peaks Medical |
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Speciality | Clinic/Center |
Location | 72 S 1st E Ste 101, Rexburg, Idaho |
Authorized Official Name and Position | Lori K Sessions (CEO) |
Authorized Official Contact | 2086244100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Grand Peaks Medical Po Box 18 Saint Anthony ID 83445-0018 Ph: (208) 356-4900 | Grand Peaks Medical 72 S 1st E Ste 101 Rexburg ID 83440-1902 Ph: (208) 356-4900 |
NPI Number | 1124403258 |
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Provider Enumeration Date | 07/30/2015 |
Last Update Date | 05/02/2024 |
Medicare PECOS PAC ID | 4385725282 |
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Medicare Enrollment ID | O20160304001867 |
Identifier | Type | State | Issuer |
---|---|---|---|
1124403258 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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