NPI age
11 years
Enumerated 2015-01-22
● Active Type 2 · Organization
Pain Care Clinic Of Idaho, P.c.
Pain Care Clinic Of Idaho, P.c. is 1 of 15 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Boese
Owner
Last NPPES update
2015-01-22
Source: monthly bulk 2026-05
How this organization compares
Across 15 active clinic/center providers in Idaho.
NPI age
11 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2015 → 2026
2015-01Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
742 E State St, Suite 150
Eagle, ID 836165941
Mailing address
742 E State St, Siuite 150
Eagle, ID 836165941
Authorized official
Edmund C Boese, MD
Owner
📞 2089393750
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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