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

CARMINE PETRACCA

Active Organization

CARMINE PETRACCA is a Health Service Clinic organization located in LEWISTON, Idaho. NPI 1649601006 is currently active in the NPPES registry. Verify at CMS.

Health Service Clinic · LEWISTON, ID

Registration Details

NPI Number
1649601006
Provider Type
Organization
NPI Issued
Dec 10, 2013 (12.714705076809 yrs)
Last Updated
Dec 10, 2013
License
ODP-634 (ID)

Practice Information

Address
939 BRYDEN AVE
LEWISTON, ID, 835015057
Browse ID providers · Browse ZIP 83501
Phone
2087431761
Fax
2087468042
Primary Specialty
Health Service Clinic
261QH0100X
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.