| Andersen Family Care | |
|
1494 West Ustick Rd 110 Meridian ID 83646 | |
| (208) 908-7797 | |
| Not Available |
| Full Name | Andersen Family Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1494 West Ustick Rd, Meridian, Idaho |
| Authorized Official Name and Position | Dallin Andersen (OWNER) |
| Authorized Official Contact | 2089540101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andersen Family Care 1494 West Ustick Rd 110 Meridian ID 83646 Ph: (208) 908-7797 | Andersen Family Care 1494 West Ustick Rd 110 Meridian ID 83646 Ph: (208) 908-7797 |
| NPI Number | 1124741277 |
|---|---|
| Provider Enumeration Date | 09/23/2022 |
| Last Update Date | 09/28/2022 |
| Medicare PECOS PAC ID | 4688041932 |
|---|---|
| Medicare Enrollment ID | O20221031000939 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124741277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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