Root Cause Integrative Medicine Llc | |
1547 S Midway Ave Suite B Ammon ID 83406 | |
(208) 497-0429 | |
(208) 497-0430 |
Full Name | Root Cause Integrative Medicine Llc |
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Speciality | Family Medicine |
Location | 1547 S Midway Ave, Ammon, Idaho |
Authorized Official Name and Position | Jordan Neil Hale (CO-OWNER/ PHYSICIAN ASSISTANT) |
Authorized Official Contact | 6509336384 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Root Cause Integrative Medicine Llc 1547 S Midway Ave Suite B Ammon ID 83406 Ph: (208) 497-0429 | Root Cause Integrative Medicine Llc 1547 S Midway Ave Suite B Ammon ID 83406 Ph: (208) 497-0429 |
NPI Number | 1447718853 |
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Provider Enumeration Date | 03/05/2019 |
Last Update Date | 04/10/2019 |
Medicare PECOS PAC ID | 2062753098 |
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Medicare Enrollment ID | O20190401001206 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447718853 | NPI | - | NPPES |
1396110169 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Laura Lee Scott |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679180244 PECOS PAC ID: 8123430204 Enrollment ID: I20201214002719 |
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Psc Radiate Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3040 E 17th St Ste A, Ammon, ID 83406 Phone: 208-557-0998 | |
Milestone Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1499 Curlew Dr, Ammon, ID 83406 Phone: 208-529-3342 Fax: 208-529-6631 | |
Bore Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1498 Midway Ave Ste 2, Ammon, ID 83406 Phone: 208-529-9930 | |
Rhs Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1675 Curlew Dr, Ammon, ID 83406 Phone: 208-523-5319 | |
Pearl Primary Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2705 E 17th St Ste B, Ammon, ID 83406 Phone: 208-497-0566 Fax: 208-346-7501 |