Idaho Minor Emergency And Family Practice Pa | |
3041 East Copper Pointe Drive Meridian ID 83642 | |
(208) 514-4400 | |
(208) 514-4404 |
Full Name | Idaho Minor Emergency And Family Practice Pa |
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Speciality | Clinic/center |
Location | 3041 East Copper Pointe Drive, Meridian, Idaho |
Authorized Official Name and Position | Raymond Paul Hooft (OWNER, CEO) |
Authorized Official Contact | 2085144400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Idaho Minor Emergency And Family Practice Pa 3041 East Copper Pointe Drive Meridian ID 83642 Ph: (208) 514-4400 | Idaho Minor Emergency And Family Practice Pa 3041 East Copper Pointe Drive Meridian ID 83642 Ph: (208) 514-4400 |
NPI Number | 1205996063 |
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Provider Enumeration Date | 12/11/2006 |
Last Update Date | 03/27/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205996063 | NPI | - | NPPES |
13D1049440 | Other | ID | CLIA NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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