| Health & Wellness Center Of Idaho Pllc | |
|
2001 S Woodruff Ave Suite 5 Idaho Falls ID 83404-6374 | |
| (208) 528-8777 | |
| (208) 528-9777 |
| Full Name | Health & Wellness Center Of Idaho Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2001 S Woodruff Ave, Idaho Falls, Idaho |
| Authorized Official Name and Position | Eric W Perttula (OWNER) |
| Authorized Official Contact | 2085288777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health & Wellness Center Of Idaho Pllc 2001 S Woodruff Ave Suite 5 Idaho Falls ID 83404-6374 Ph: (208) 528-8777 | Health & Wellness Center Of Idaho Pllc 2001 S Woodruff Ave Suite 5 Idaho Falls ID 83404-6374 Ph: (208) 528-8777 |
| NPI Number | 1306981782 |
|---|---|
| Provider Enumeration Date | 02/21/2007 |
| Last Update Date | 07/11/2016 |
| Medicare PECOS PAC ID | 0143203844 |
|---|---|
| Medicare Enrollment ID | O20040612000043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306981782 | NPI | - | NPPES |
| 8069929 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M8241 (Idaho) | Primary |
| Provider Name | Eric W Perttula |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710988894 PECOS PAC ID: 5395728091 Enrollment ID: I20040708001473 |
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