| Virtare Health Physician Services Of Idaho Pllc | |
|
3597 E Monarch Sky Ln Ste 240 Meridian ID 83646-1055 | |
| (855) 745-8400 | |
| Not Available |
| Full Name | Virtare Health Physician Services Of Idaho Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3597 E Monarch Sky Ln Ste 240, Meridian, Idaho |
| Authorized Official Name and Position | Franklin Moses (CEO) |
| Authorized Official Contact | 8557458400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Virtare Health Physician Services Of Idaho Pllc 10890 Thornmint Rd San Diego CA 92127-2402 Ph: (855) 745-8400 | Virtare Health Physician Services Of Idaho Pllc 3597 E Monarch Sky Ln Ste 240 Meridian ID 83646-1055 Ph: (855) 745-8400 |
| NPI Number | 1043099310 |
|---|---|
| Provider Enumeration Date | 09/26/2023 |
| Last Update Date | 06/07/2024 |
| Medicare PECOS PAC ID | 8921440306 |
|---|---|
| Medicare Enrollment ID | O20240530003096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043099310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Brian L Anderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396788469 PECOS PAC ID: 2466531710 Enrollment ID: I20240607001742 |
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