| Sipi Clinic Llc | |
|
176 Falls Ave Twin Falls ID 83301-2306 | |
| (208) 733-3181 | |
| (208) 733-3168 |
| Full Name | Sipi Clinic Llc |
|---|---|
| Speciality | Specialist |
| Location | 176 Falls Ave, Twin Falls, Idaho |
| Authorized Official Name and Position | Denise Rue (OFFICE MANAGER) |
| Authorized Official Contact | 2087333181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sipi Clinic Llc 176 Falls Ave Twin Falls ID 83301-2306 Ph: (208) 733-3181 | Sipi Clinic Llc 176 Falls Ave Twin Falls ID 83301-2306 Ph: (208) 733-3181 |
| NPI Number | 1780398586 |
|---|---|
| Provider Enumeration Date | 01/06/2023 |
| Last Update Date | 05/06/2024 |
| Medicare PECOS PAC ID | 5890167233 |
|---|---|
| Medicare Enrollment ID | O20230210000802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780398586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (Not Available)) | Primary |
| Provider Name | Clinton L Dille |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306947569 PECOS PAC ID: 1456326958 Enrollment ID: I20040828000100 |
| Provider Name | Michael R Mcentire |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477875094 PECOS PAC ID: 4284827684 Enrollment ID: I20140801002362 |
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