| Sterling Provider Group | |
|
2201 Thain Grade Lewiston ID 83501-4118 | |
| (208) 717-3100 | |
| (208) 717-3099 |
| Full Name | Sterling Provider Group |
|---|---|
| Speciality | Clinic/center - Urgent Care |
| Location | 2201 Thain Grade, Lewiston, Idaho |
| Authorized Official Name and Position | Corbin Bunnage (PROVIDER/OWNER) |
| Authorized Official Contact | 2085429111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sterling Provider Group 740 S Woodruff Ave Idaho Falls ID 83401-5285 Ph: (208) 542-9111 | Sterling Provider Group 2201 Thain Grade Lewiston ID 83501-4118 Ph: (208) 717-3100 |
| NPI Number | 1144975152 |
|---|---|
| Provider Enumeration Date | 02/17/2022 |
| Last Update Date | 07/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144975152 | NPI | - | NPPES |
| 13D2264847 | Other | ID | CLIA |
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