| Community Council Of Idaho, Inc. | |
|
4002 E 397 N Rigby ID 83442 | |
| (208) 528-7655 | |
| (208) 524-9390 |
| Full Name | Community Council Of Idaho, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4002 E 397 N, Rigby, Idaho |
| Authorized Official Name and Position | Marlen Villegas (MEDICAL BILLING SPECIALIST) |
| Authorized Official Contact | 2085287655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Council Of Idaho, Inc. 2100 Alan St Idaho Falls ID 83404 Ph: (208) 528-7655 | Community Council Of Idaho, Inc. 4002 E 397 N Rigby ID 83442 Ph: (208) 528-7655 |
| NPI Number | 1710664834 |
|---|---|
| Provider Enumeration Date | 06/30/2023 |
| Last Update Date | 11/13/2023 |
| Medicare PECOS PAC ID | 6204877467 |
|---|---|
| Medicare Enrollment ID | O20240705000969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710664834 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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