EASTERN IDAHO CARDIOLOGY ASSOCIATES PLLC NPI 1508866260

NPI Information

NPI: 1508866260
Provider Name: EASTERN IDAHO CARDIOLOGY ASSOCIATES, PLLC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
2001 S WOODRUFF AVE
SUITE 12A
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 524-2255
Get Directions

EASTERN IDAHO CARDIOLOGY ASSOCIATES, PLLC is a cardiovascular disease internal medicine in Idaho Falls, ID. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. EASTERN IDAHO CARDIOLOGY ASSOCIATES, PLLC NPI is 1508866260. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2001 S WOODRUFF AVE
SUITE 12A
IDAHO FALLS, ID
ZIP 83404-374
Phone: (208) 524-2255
Fax: (208) 524-2256

The provider's authorized official is Patrick D Gorman .
The authorized official title is Ceo and has the following contact phone number (208) 524-2255.

The enumeration date for this NPI number is 7/26/2005 and was last updated on 8/19/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	=========	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	805326000	MEDICAID	IDAHO
2	1375782	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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