| Family Medical Care Pllc | |
|
265 W Prairie Shopping Ctr Hayden ID 83835-9855 | |
| (208) 772-7850 | |
| (208) 772-2313 |
| Full Name | Family Medical Care Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 265 W Prairie Shopping Ctr, Hayden, Idaho |
| Authorized Official Name and Position | John Lawrence Torquato (PRESIDENT) |
| Authorized Official Contact | 2087727850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Care Pllc 265 W Prairie Shopping Ctr Hayden ID 83835-9855 Ph: (208) 772-7850 | Family Medical Care Pllc 265 W Prairie Shopping Ctr Hayden ID 83835-9855 Ph: (208) 772-7850 |
| NPI Number | 1053615427 |
|---|---|
| Provider Enumeration Date | 12/29/2010 |
| Last Update Date | 12/29/2010 |
| Medicare PECOS PAC ID | 6305029331 |
|---|---|
| Medicare Enrollment ID | O20110330000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053615427 | NPI | - | NPPES |
| 8058948 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-7938 (Idaho) | Primary |
| 363AM0700X | Physician Assistant - Medical | PAG-019 (Idaho) | Secondary |
| Provider Name | John L Torquato |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417901638 PECOS PAC ID: 4688696073 Enrollment ID: I20100524000859 |
| Provider Name | Rupelin D Pichot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891112041 PECOS PAC ID: 1052535150 Enrollment ID: I20190109000599 |
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