| Public Health District Iv | |
|
707 N Armstrong Pl Boise ID 83704-0825 | |
| (208) 375-5211 | |
| (208) 327-8500 |
| Full Name | Public Health District Iv |
|---|---|
| Speciality | Public Health or Welfare |
| Location | 707 N Armstrong Pl, Boise, Idaho |
| Authorized Official Name and Position | Sarah Mcmurtry (CLINIC MANAGER) |
| Authorized Official Contact | 2083277400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Public Health District Iv 707 N Armstrong Pl Boise ID 83704-0825 Ph: (208) 375-5211 | Public Health District Iv 707 N Armstrong Pl Boise ID 83704-0825 Ph: (208) 375-5211 |
| NPI Number | 1326009648 |
|---|---|
| Provider Enumeration Date | 03/28/2006 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Medicare PECOS PAC ID | 3274887179 |
|---|---|
| Medicare Enrollment ID | O20181113000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326009648 | NPI | - | NPPES |
| 805808800 | Medicaid | ID | |
| 002469400 | Medicaid | ID | |
| 002831400 | Medicaid | ID | |
| 806152200 | Medicaid | ID | |
| DH041 | Other | ID | BLUE CROSS OF IDAHO |
| 000010007076 | Other | ID | REGENCE BLUE SHIELD OF ID |
| 002469200 | Medicaid | ID | |
| 002469700 | Medicaid | ID | |
| 806919800 | Medicaid | ID |
| Provider Name | Sandy Leigh Mudge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366704017 PECOS PAC ID: 8224268164 Enrollment ID: I20150818004653 |
| Provider Name | Megan K Fitzmaurice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336523703 PECOS PAC ID: 1052696226 Enrollment ID: I20170330002197 |
| Provider Name | Savannah M Klinginsmith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669038220 PECOS PAC ID: 1153752514 Enrollment ID: I20200701001679 |
| Provider Name | Natasha Michele King-anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003579269 PECOS PAC ID: 2264811249 Enrollment ID: I20220622000844 |
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