| Primary Health Medical Group | |
|
6052 W State St Boise ID 83703-2739 | |
| (208) 344-7799 | |
| (208) 344-7152 |
| Full Name | Primary Health Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 6052 W State St, Boise, Idaho |
| Authorized Official Name and Position | David Peterman (PRESIDENT) |
| Authorized Official Contact | 2089556522 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Health Medical Group Po Box 191050 Boise ID 83719-1050 Ph: (208) 955-6500 | Primary Health Medical Group 6052 W State St Boise ID 83703-2739 Ph: (208) 344-7799 |
| NPI Number | 1568608800 |
|---|---|
| Provider Enumeration Date | 12/16/2008 |
| Last Update Date | 02/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568608800 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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