| Physician Management Services Of Idaho, Llc | |
|
113 S Apple St Shoshone ID 83352-5287 | |
| (888) 829-8550 | |
| Not Available |
| Full Name | Physician Management Services Of Idaho, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 113 S Apple St, Shoshone, Idaho |
| Authorized Official Name and Position | Brett Kenefick (PRESIDENT) |
| Authorized Official Contact | 8888298550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Management Services Of Idaho, Llc 3113 Lawton Rd Orlando FL 32803-3531 Ph: (888) 829-8550 | Physician Management Services Of Idaho, Llc 113 S Apple St Shoshone ID 83352-5287 Ph: (888) 829-8550 |
| NPI Number | 1215688346 |
|---|---|
| Provider Enumeration Date | 01/11/2022 |
| Last Update Date | 01/11/2022 |
| Medicare PECOS PAC ID | 6800270984 |
|---|---|
| Medicare Enrollment ID | O20220909000126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215688346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Southern Idaho Diabetes Education Program Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Nw Rail St, Shoshone, ID 83352 Phone: 208-944-4747 Fax: 208-886-2634 | |
Shoshone Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 S Apple St, Shoshone, ID 83352 Phone: 208-886-2222 |