MOUNTAIN WEST MEDICAL SERVICES PLLC NPI 1457894339

NPI Information

NPI: 1457894339
Provider Name: MOUNTAIN WEST MEDICAL SERVICES PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 13D2125343

Address:
1067 S WELLS ST
SUITE#110
MERIDIAN, ID
ZIP 83642
Phone: (208) 229-8739
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MOUNTAIN WEST MEDICAL SERVICES PLLC is a primary care clinic center in Meridian, ID. MOUNTAIN WEST MEDICAL SERVICES PLLC NPI is 1457894339. The provider is registered as an organization entity type.

The provider's business location address is:

1067 S WELLS ST
SUITE#110
MERIDIAN, ID
ZIP 83642-997
Phone: (208) 229-8739
Fax: (208) 895-8540

The provider's authorized official is John Kenneth Mcrae .
The authorized official title is Dr. Of Nurse Practioner and has the following contact phone number (208) 229-8739.

The CLIA number assigned to this NPI record is 13D2125343 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/28/2016 and was last updated on 7/14/2017.

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	261QP2300X	Clinic/Center	Primary Care	54169	IDAHO	Yes

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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