| C/o Physicians Immeidate Care Of Twin | |
|
1252 Bennett Ave Suite B Burley ID 83318 | |
| (208) 617-0656 | |
| (208) 647-0659 |
| Full Name | C/o Physicians Immeidate Care Of Twin |
|---|---|
| Speciality | Family Medicine |
| Location | 1252 Bennett Ave, Burley, Idaho |
| Authorized Official Name and Position | Jeremy B Haymore (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2083122242 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C/o Physicians Immeidate Care Of Twin 260 Falls Ave Ste C Twin Falls ID 83301-3370 Ph: (208) 736-7422 | C/o Physicians Immeidate Care Of Twin 1252 Bennett Ave Suite B Burley ID 83318 Ph: (208) 617-0656 |
| NPI Number | 1487151882 |
|---|---|
| Provider Enumeration Date | 04/11/2018 |
| Last Update Date | 02/01/2019 |
| Medicare PECOS PAC ID | 1557614369 |
|---|---|
| Medicare Enrollment ID | O20190306000972 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487151882 | NPI | - | NPPES |
| 1487151882 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-4391 (Idaho) | Primary |
| Provider Name | Jeremy Haymore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265547582 PECOS PAC ID: 6709989387 Enrollment ID: I20081028000788 |
Cassia Regional Hospital Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Hiland Ave, Burley, ID 83318 Phone: 208-677-6215 | |
Wayne H Blauer Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Hiland Ave, Ste L3, Burley, ID 83318 Phone: 208-678-2283 Fax: 208-677-2483 | |
Alan S. Nelson D.o. Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1404 Pomerelle Ave., Suite A2, Burley, ID 83318 Phone: 208-878-8817 | |
Dot Burley Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 E 21st St, Burley, ID 83318 Phone: 208-678-2192 Fax: 208-678-6077 | |
Albion Valley Health Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 West 5th Street, Burley, ID 83318 Phone: 208-312-9740 Fax: 208-678-0910 | |
Cassia Medical Imaging Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Hiland Ave, Burley, ID 83318 Phone: 801-442-1400 Fax: 801-442-0641 | |
B R Boehmer Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1335 Albion Ave, Burley, ID 83318 Phone: 208-878-2271 |