| Sandpoint Health Care, Pllc | |
|
1215 Michigan St Ste B Sandpoint ID 83864-5014 | |
| (208) 946-1730 | |
| Not Available |
| Full Name | Sandpoint Health Care, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1215 Michigan St Ste B, Sandpoint, Idaho |
| Authorized Official Name and Position | Nichole Grimm (FAMILY NURSE PRACTITIONER/OWNER) |
| Authorized Official Contact | 2089461730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandpoint Health Care, Pllc 614 Creekside Ln Sandpoint ID 83864-2325 Ph: (208) 946-1730 | Sandpoint Health Care, Pllc 1215 Michigan St Ste B Sandpoint ID 83864-5014 Ph: (208) 946-1730 |
| NPI Number | 1548741820 |
|---|---|
| Provider Enumeration Date | 08/24/2018 |
| Last Update Date | 09/18/2018 |
| Medicare PECOS PAC ID | 2860745387 |
|---|---|
| Medicare Enrollment ID | O20181031001614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548741820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | NP1113A (Idaho) | Primary |
| Provider Name | Nichole S Grimm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669756813 PECOS PAC ID: 7214102557 Enrollment ID: I20111214000784 |
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