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KOOTENAI URGENT CARE LLC NPI 1821312356


NPI Information

NPI: 1821312356
Provider Name: KOOTENAI URGENT CARE LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
700 W IRONWOOD DR
SUITE 170E
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 667-9110
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KOOTENAI URGENT CARE LLC is a family medicine in Coeur D Alene, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KOOTENAI URGENT CARE LLC NPI is 1821312356. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

700 W IRONWOOD DR
SUITE 170E
COEUR D ALENE, ID
ZIP 83814-656
Phone: (208) 667-9110
Fax: (208) 676-1272

The provider's authorized official is Eric Koelsch .
The authorized official title is Executive Director and has the following contact phone number (208) 676-0145.

The enumeration date for this NPI number is 3/26/2010 and was last updated on 3/22/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician AssistantNo
2363L00000XNurse PractitionerNo
3207Q00000XFamily MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11369049OTHERIDAHOMEDICARE PART B PTAN
2DQ3168OTHERIDAHORR MEDICARE
36396800001MEDICARE NSCIDAHO

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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