| North Idaho Medical Care Centers Pllc | |
|
1701 Lincoln Way Coeur D Alene ID 83814-2537 | |
| (208) 667-9110 | |
| Not Available |
| Full Name | North Idaho Medical Care Centers Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1701 Lincoln Way, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Thomas J Legel (CFO) |
| Authorized Official Contact | 2086662000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Idaho Medical Care Centers Pllc 927 E Polston Ave Ste 303 Post Falls ID 83854-9811 Ph: (208) 664-3313 | North Idaho Medical Care Centers Pllc 1701 Lincoln Way Coeur D Alene ID 83814-2537 Ph: (208) 667-9110 |
| NPI Number | 1316038904 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 09/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316038904 | NPI | - | NPPES |
| 1112918 | Other | ID | MEDICARE |
| 002606200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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