| Core Medicine Of Idaho | |
|
4605 Enterprise Way Ste 101 Caldwell ID 83605-8360 | |
| (208) 353-7518 | |
| Not Available |
| Full Name | Core Medicine Of Idaho |
|---|---|
| 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 Of Idaho 2667 E Gala Ct Ste 130 Meridian ID 83642-2788 Ph: (208) 795-5090 | Core Medicine Of Idaho 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 | Keira Elaine Toone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780092130 PECOS PAC ID: 3678790540 Enrollment ID: I20240205003640 |
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