| Primary Health Medical Group | |
|
1648 Nw 1st Street Meridian ID 83642 | |
| (208) 888-9393 | |
| (208) 888-9525 |
| Full Name | Primary Health Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1648 Nw 1st Street, Meridian, Idaho |
| Authorized Official Name and Position | David Peterman (PRESIDENT) |
| Authorized Official Contact | 2089556506 |
| 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 1648 Nw 1st Street Meridian ID 83642 Ph: (208) 888-9393 |
| NPI Number | 1407092794 |
|---|---|
| Provider Enumeration Date | 12/17/2008 |
| Last Update Date | 12/09/2016 |
| Medicare PECOS PAC ID | 3971544685 |
|---|---|
| Medicare Enrollment ID | O20111017000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407092794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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