| Core Medicine Idaho, Llc | |
|
4605 Enterprise Way Ste 101 Caldwell ID 83605-8360 | |
| (208) 353-7518 | |
| Not Available |
| Full Name | Core Medicine Idaho, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4605 Enterprise Way, Caldwell, Idaho |
| Authorized Official Name and Position | Sophie Rath (MANANGER) |
| Authorized Official Contact | 2087955090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Core Medicine Idaho, Llc 2667 E Gala Ct Ste 130 Meridian ID 83642-2788 Ph: (208) 795-5090 | Core Medicine Idaho, Llc 4605 Enterprise Way Ste 101 Caldwell ID 83605-8360 Ph: (208) 353-7518 |
| NPI Number | 1043927882 |
|---|---|
| Provider Enumeration Date | 11/01/2022 |
| Last Update Date | 01/16/2024 |
| Medicare PECOS PAC ID | 8921441163 |
|---|---|
| Medicare Enrollment ID | O20240205003476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043927882 | NPI | - | NPPES |
| 1295734796 | Medicaid | ID |
| Provider Name | Kari M Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841456191 PECOS PAC ID: 1850468208 Enrollment ID: I20080926000199 |
| Provider Name | Jaimee Kay Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861794026 PECOS PAC ID: 0244405546 Enrollment ID: I20111215000314 |
| Provider Name | David Craig Sjostrand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053850164 PECOS PAC ID: 2668744533 Enrollment ID: I20170828002334 |
| Provider Name | Jennifer Lyn King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477958494 PECOS PAC ID: 2668798588 Enrollment ID: I20181115000564 |
| Provider Name | Tina M Bossolono-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891264545 PECOS PAC ID: 9638418031 Enrollment ID: I20190301001302 |
| Provider Name | Keira Elaine Toone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780092130 PECOS PAC ID: 3678790540 Enrollment ID: I20240205003640 |
Saint Alphonsus Physician Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 Elm, Suite 100, Caldwell, ID 83605 Phone: 208-459-7415 Fax: 208-454-5113 | |
Alliance Medical Group, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 512 N 21st Ave, Caldwell, ID 83605 Phone: 208-809-2875 Fax: 208-809-2876 | |
Saint Alphonsus Regional Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St, Suite 100, Caldwell, ID 83605 Phone: 208-459-7415 Fax: 208-453-3232 | |
West Idaho Imedcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 22872 Aura Vista Way, Caldwell, ID 83607 Phone: 808-294-7862 | |
West Valley Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3115 Medical Dr, Caldwell, ID 83605 Phone: 208-459-4641 | |
No8 Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 512 E Elm St, Caldwell, ID 83605 Phone: 208-370-7004 |