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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

IDAHO STREET MEDICAL CLINIC

Active Organization

IDAHO STREET MEDICAL CLINIC is a Rural Health Clinic organization located in HOMEDALE, Idaho. NPI 1063970143 is currently active in the NPPES registry. Verify at CMS.

Rural Health Clinic · HOMEDALE, ID

Registration Details

NPI Number
1063970143
Provider Type
Organization
NPI Issued
Mar 7, 2019 (7.2940605796657 yrs)
Last Updated
Mar 7, 2019

Practice Information

Address
126 IDAHO AVE.
HOMEDALE, ID, 836288362
Browse ID providers · Browse ZIP 83628
Phone
2088594103
Primary Specialty
Rural Health Clinic
261QR1300X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.