Organization Name: | NORTH IDAHO MEDICAL CARE CENTERS |
NPI Number: | 1548414733 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHANNON K HARRIS (BUSINESS DIRECTOR) |
Mailing Address: | 1701 Lincoln Way Coeur D Alene |
State: | ID US |
Postal Code: | 838142537 |
Phone Number: | 2086679110 |
Fax Number: | 2086670125 |
NPI Enumeration Date: | 11/14/2008 |
NPI Last Update Date: | 11/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |