| Valley Vista Care Services - Family Practice | |
|
820 Elm St St Maries ID 83861-2119 | |
| (208) 245-4576 | |
| (208) 245-2138 |
| Full Name | Valley Vista Care Services - Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 820 Elm St, St Maries, Idaho |
| Authorized Official Name and Position | Gail Mills (CORPORATE COMPLIANCE MANAGER) |
| Authorized Official Contact | 2082454576 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Vista Care Services - Family Practice 820 Elm St St Maries ID 83861-2119 Ph: (208) 245-4576 | Valley Vista Care Services - Family Practice 820 Elm St St Maries ID 83861-2119 Ph: (208) 245-4576 |
| NPI Number | 1134296437 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134296437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-5955 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | O-130 (Idaho) | Primary |
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