NPI age
18 years
Enumerated 2007-11-07
Across 104 active clinic/center providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | 000010006394 | REGENCE BLUE SHIELD |
| 05 (ID) | 002560500 | |
| 01 (ID) | 88609 | BLUE CROSS OF IDAHO |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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