| B R Boehmer Md Pa | |
|
1335 Albion Ave Burley ID 83318-1817 | |
| (208) 878-2271 | |
| Not Available |
| Full Name | B R Boehmer Md Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1335 Albion Ave, Burley, Idaho |
| Authorized Official Name and Position | Bernard R Boehmer (OWNER) |
| Authorized Official Contact | 2088782271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| B R Boehmer Md Pa 1335 Albion Ave Burley ID 83318-1817 Ph: () - | B R Boehmer Md Pa 1335 Albion Ave Burley ID 83318-1817 Ph: (208) 878-2271 |
| NPI Number | 1447565627 |
|---|---|
| Provider Enumeration Date | 08/12/2010 |
| Last Update Date | 08/12/2010 |
| Medicare PECOS PAC ID | 8527182963 |
|---|---|
| Medicare Enrollment ID | O20100907001126 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447565627 | NPI | - | NPPES |
| 002799800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | M6848 (Idaho) | Primary |
| Provider Name | Bernard R Boehmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902891484 PECOS PAC ID: 5193840544 Enrollment ID: I20100909000254 |
| Provider Name | Steven Colby Boehmer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336563063 PECOS PAC ID: 6406162668 Enrollment ID: I20210616001557 |
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