| Primary Health Medical Group | |
|
1623 South Wells Avenue Meridian ID 83642 | |
| (208) 489-1450 | |
| (208) 489-1451 |
| Full Name | Primary Health Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1623 South Wells Avenue, Meridian, 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 |
|---|---|
| Primary Health Medical Group Po Box 191050 Boise ID 83719-1050 Ph: (208) 955-6500 | Primary Health Medical Group 1623 South Wells Avenue Meridian ID 83642 Ph: (208) 489-1450 |
| NPI Number | 1033534276 |
|---|---|
| Provider Enumeration Date | 02/25/2014 |
| Last Update Date | 02/25/2014 |
| Medicare PECOS PAC ID | 3971544685 |
|---|---|
| Medicare Enrollment ID | O20150619001486 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033534276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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