| Southern Idaho Diabetes Education Program | |
|
108 Nw Rail St Shoshone ID 83352 | |
| (208) 944-4747 | |
| (208) 886-2634 |
| Full Name | Southern Idaho Diabetes Education Program |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 108 Nw Rail St, Shoshone, Idaho |
| Authorized Official Name and Position | Kathryn Evalena Pike (SIDEP COORDINATOR) |
| Authorized Official Contact | 2089444747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Idaho Diabetes Education Program 113 S Apple St Shoshone ID 83352-5287 Ph: (208) 886-6222 | Southern Idaho Diabetes Education Program 108 Nw Rail St Shoshone ID 83352 Ph: (208) 944-4747 |
| NPI Number | 1154572311 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 10/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154572311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Physician Management Services Of Idaho, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 S Apple St, Shoshone, ID 83352 Phone: 888-829-8550 | |
Shoshone Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 S Apple St, Shoshone, ID 83352 Phone: 208-886-2222 |