| Willow Valley | |
|
47 N 1st E Preston ID 83263-1325 | |
| (208) 852-0137 | |
| (208) 852-3812 |
| Full Name | Willow Valley |
|---|---|
| Speciality | Clinic/Center |
| Location | 47 N 1st E, Preston, Idaho |
| Authorized Official Name and Position | Paul Smart (C.F.O.) |
| Authorized Official Contact | 2088520137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Valley 44 N 1st E Preston ID 83263-1326 Ph: (208) 852-0137 | Willow Valley 47 N 1st E Preston ID 83263-1325 Ph: (208) 852-0137 |
| NPI Number | 1144663543 |
|---|---|
| Provider Enumeration Date | 04/16/2013 |
| Last Update Date | 07/21/2021 |
| Medicare PECOS PAC ID | 8820909104 |
|---|---|
| Medicare Enrollment ID | O20140428000889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144663543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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