Primary Health Medical Group | |
4971 W. Overland Road Boise ID 83705 | |
(208) 472-5050 | |
(208) 472-5051 |
Full Name | Primary Health Medical Group |
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Speciality | Family Medicine |
Location | 4971 W. Overland Road, Boise, Idaho |
Authorized Official Name and Position | David Peterman (PRESIDENT) |
Authorized Official Contact | 2089556522 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Health Medical Group Po Box 191050 Boise ID 83719-1050 Ph: (208) 955-6500 | Primary Health Medical Group 4971 W. Overland Road Boise ID 83705 Ph: (208) 472-5050 |
NPI Number | 1871969246 |
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Provider Enumeration Date | 08/19/2015 |
Last Update Date | 08/19/2015 |
Medicare PECOS PAC ID | 3971544685 |
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Medicare Enrollment ID | O20151103000690 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871969246 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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