| Christopher Kolobow, Np-c Llc | |
|
6737b Cody St Bonners Ferry ID 83805-8504 | |
| (208) 267-2225 | |
| (208) 267-2225 |
| Full Name | Christopher Kolobow, Np-c Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6737b Cody St, Bonners Ferry, Idaho |
| Authorized Official Name and Position | Christopher Michael Kolobow (BUSINESS OWNER & NURSE PRACTIONER) |
| Authorized Official Contact | 2082672255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Kolobow, Np-c Llc Po Box P Bonners Ferry ID 83805-1199 Ph: (208) 304-8938 | Christopher Kolobow, Np-c Llc 6737b Cody St Bonners Ferry ID 83805-8504 Ph: (208) 267-2225 |
| NPI Number | 1992325815 |
|---|---|
| Provider Enumeration Date | 04/21/2020 |
| Last Update Date | 04/21/2020 |
| Medicare PECOS PAC ID | 7517389604 |
|---|---|
| Medicare Enrollment ID | O20200618000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992325815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Christopher M Kolobow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700277688 PECOS PAC ID: 0941529895 Enrollment ID: I20150428000634 |
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