Moscow Medical, P.a. | |
213 N Main St Moscow ID 83843-2700 | |
(208) 882-7565 | |
Not Available |
Full Name | Moscow Medical, P.a. |
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Speciality | Family Medicine |
Location | 213 N Main St, Moscow, Idaho |
Authorized Official Name and Position | Kathy Cornish (BILLING MANAGER) |
Authorized Official Contact | 2087463653 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Moscow Medical, P.a. 213 N Main St Moscow ID 83843-2700 Ph: (208) 882-7565 | Moscow Medical, P.a. 213 N Main St Moscow ID 83843-2700 Ph: (208) 882-7565 |
NPI Number | 1871646976 |
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Provider Enumeration Date | 01/19/2007 |
Last Update Date | 03/31/2009 |
Medicare PECOS PAC ID | 8325006463 |
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Medicare Enrollment ID | O20071010000836 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871646976 | NPI | - | NPPES |
133858 | Other | ID | MEDICARE RHC |
002262200 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Idaho) | Primary |
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