| Community Council Of Idaho, Inc. | |
|
1491 Parkway Dr Blackfoot ID 83221-1667 | |
| (208) 782-0500 | |
| (844) 328-7224 |
| Full Name | Community Council Of Idaho, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1491 Parkway Dr, Blackfoot, Idaho |
| Authorized Official Name and Position | Arnold Cantu (CLINIC ADMINISTRATOR) |
| 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 83404-5801 Ph: (208) 528-7655 | Community Council Of Idaho, Inc. 1491 Parkway Dr Blackfoot ID 83221-1667 Ph: (208) 782-0500 |
| NPI Number | 1356416861 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 11/13/2023 |
| Medicare PECOS PAC ID | 6204877467 |
|---|---|
| Medicare Enrollment ID | O20051019000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356416861 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Idaho Physicians Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-3800 | |
Blackfoot Medical Clinic Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
Blackfoot Medical Clinic, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 Fax: 208-785-8185 | |
Intercept Systems, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 N 700 W, Blackfoot, ID 83221 Phone: 208-201-0795 | |
Peak Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1495 Parkway Dr Ste C, Blackfoot, ID 83221 Phone: 208-643-4231 Fax: 208-643-4235 | |
Bmh, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-782-3700 |