DOCTOR'S HOSPICE OF IDAHO LLC NPI 1871946483

NPI Information

NPI: 1871946483
Provider Name: DOCTOR'S HOSPICE OF IDAHO LLC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 13D2131891

Address:
1552 N CRESTMONT DR STE B
MERIDIAN, ID
ZIP 83642
Phone: (208) 985-2260
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DOCTOR'S HOSPICE OF IDAHO LLC is a hospice care community based in Meridian, ID. DOCTOR'S HOSPICE OF IDAHO LLC NPI is 1871946483. The provider is registered as an organization entity type.

The provider's business location address is:

1552 N CRESTMONT DR STE B
MERIDIAN, ID
ZIP 83642-191
Phone: (208) 985-2260
Fax: (208) 985-2261

The provider's authorized official is Cody Matthew Freston .
The authorized official title is Owner and has the following contact phone number (208) 985-2260.

The CLIA number assigned to this NPI record is 13D2131891 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/19/2016 and was last updated on 12/13/2022.

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	251G00000X	Hospice Care, Community Based				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	1871946483	MEDICAID	IDAHO

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: 4/28/2024

NPI Synchronization or Removal

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