| Capital City Health Pllc | |
|
3295 W Elder St Ste 209 Boise ID 83705-4772 | |
| (866) 316-9062 | |
| Not Available |
| Full Name | Capital City Health Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3295 W Elder St Ste 209, Boise, Idaho |
| Authorized Official Name and Position | Jessica Ahlers (OWNER) |
| Authorized Official Contact | 8663169062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital City Health Pllc 2742 N Mckinney St Boise ID 83704-6022 Ph: () - | Capital City Health Pllc 3295 W Elder St Ste 209 Boise ID 83705-4772 Ph: (866) 316-9062 |
| NPI Number | 1295500478 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 11/20/2023 |
| Medicare PECOS PAC ID | 0345684700 |
|---|---|
| Medicare Enrollment ID | O20240214001286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295500478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Jessica L Ahlers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528661154 PECOS PAC ID: 2860804101 Enrollment ID: I20201210001720 |
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