INTERMOUNTAIN DIAGNOSTICS INC. NPI 1154429058

NPI Information

NPI: 1154429058
Provider Name: INTERMOUNTAIN DIAGNOSTICS, INC.
Classification: Specialist/Technologist Cardiovascular - 246XS1301X
Entity Type: Organization

Specialization: Sonography

Address:
200 N 4TH ST
SUITE 15
BOISE, ID
ZIP 83702
Phone: (208) 331-0436
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INTERMOUNTAIN DIAGNOSTICS, INC. is a sonography specialist technologist cardiovascular in Boise, ID. INTERMOUNTAIN DIAGNOSTICS, INC. NPI is 1154429058. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

200 N 4TH ST
SUITE 15
BOISE, ID
ZIP 83702-001
Phone: (208) 331-0436
Fax: (208) 424-8501

The provider's authorized official is L. Kathleen Cammack .
The authorized official title is Billing Agent and has the following contact phone number (208) 337-4254.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 8/22/2020.

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	246XS1301X	Specialist/Technologist Cardiovascular	Sonography	NONE GIVEN IN IDAHO	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	000010017912	OTHER	IDAHO	BLUE SHIELD
2	1538377	OTHER	IDAHO	UNITED MINE WORKERS
3	170283	OTHER	IDAHO	OMAP (OREGON MEDICAL)
4	8D244	OTHER	IDAHO	BLUE CROSS

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

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