| Payette Lakes Medical Clinic, Pa | |
|
101 Council Avenue Suite C Council ID 83612 | |
| (208) 253-4915 | |
| (208) 253-4917 |
| Full Name | Payette Lakes Medical Clinic, Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 101 Council Avenue, Council, Idaho |
| Authorized Official Name and Position | Jacqueline R Bruns (VP - PHYSICIAN SERVICES) |
| Authorized Official Contact | 2086344061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Payette Lakes Medical Clinic, Pa Po Box 1047 Mccall ID 83638-1047 Ph: (208) 634-2225 | Payette Lakes Medical Clinic, Pa 101 Council Avenue Suite C Council ID 83612 Ph: (208) 253-4915 |
| NPI Number | 1881725331 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 03/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881725331 | NPI | - | NPPES |
| 8G122 | Other | ID | BC |
| 000010139844 | Other | ID | BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Adams County Health Center Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 205 N Berkley, Council, ID 83612 Phone: 208-253-4242 Fax: 208-253-6849 |