RENU MEDISPA NPI 1407129125

NPI Information

  • NPI: 1407129125
  • Provider Name: RENU MEDISPA
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 951 E PLAZA DR
    SUITE 150
    EAGLE, ID
    ZIP 83616
  • Phone: (208) 939-4456

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NPI Details

RENU MEDISPA is a clinic center in Eagle, ID. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). RENU MEDISPA NPI is 1407129125. The provider is registered as an organization entity type.

The provider's business location address is:

951 E PLAZA DR
SUITE 150
EAGLE, ID
ZIP 83616-566
Phone: (208) 939-4456
Fax: (208) 287-2200

The provider's authorized official is Tawni Weaver .
The authorized official title is Director and has the following contact phone number (208) 939-4456.

The enumeration date for this NPI number is 2/10/2012 and was last updated on 4/30/2012.

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
1261Q00000XClinic/CenterNP784AIDAHOYes

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: 11/21/2025

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