ID DEPT OF HEALTH & WELFARE CSHP (PKU FORM) (NPI# 1871716118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871716118 |
| Entity Type | Organization |
| Organization Name | ID DEPT OF HEALTH & WELFARE CSHP (PKU FORM) |
| Practice Address |
450 W State St 4th Floor Boise ID 83702-6056 |
| Mailing Address |
Po Box 83720 4th Floor Boise ID 83720-0036 |
| Practice Telephone | 2083344935 |
| Practice Fax Number | 2083327307 |
| Mailing Telephone | 2083344935 |
| Mailing Fax Number | 2083327307 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PAIGE FINCHER (ACTING PROGRAM MANAGER) |
| Authorized Official Telephone | 2083344935 |
| Authorized Official Credential | BSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 0028484 | 05 | |
| ID | BLUE SHIELD | 000010022948 | 01 |
| ID | BLUE CROSS OF ID | HW207 | 01 |
| Street Address |
450 W STATE ST 4TH FLOOR |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194773804 | Ben H. Godfrey | Pediatrics | 450 W State St, Suite 100, Boise, ID 83702-6056 | 2006-05-05 |
| 1710269832 | Teresa Bernadette Kobza | Dietitian, Registered | 450 W State St, Boise, ID 83702 | 2011-09-14 |
| 1710287149 | Idaho Division of Behavioral Health | Community/Behavioral Health | 450 W State St, Boise, ID 83702-6056 | 2010-11-02 |
| 1174781959 | Christine Gabriele Hahn | Internal Medicine | 450 W State St, 4th Floor, Boise, ID 83702-6056 | 2008-05-28 |
| 1275655995 | Id Dept of Health & Welfare Cshp (gen) | Pediatrics | 450 W State St, 4th Floor, Boise, ID 83702-6056 | 2007-04-04 |
| 1770532350 | Mindy B. Gaddis | Pediatrics | 450 W State St, Suite 100, Boise, ID 83702-6056 | 2006-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710528211 | Live Well Cpap and Medical Supply | Durable Medical Equipment & Medical Supplies | 11513 W Fairview Ave Ste 103, Boise, ID 83713-7887 | 2019-10-05 |
| 1831741354 | Sound Sleep Medical LLC | Durable Medical Equipment & Medical Supplies | 1070 N Curtis Rd Ste 110, Boise, ID 83706-1248 | 2019-07-15 |
| 1023581055 | Dermaclinical, Inc. | Durable Medical Equipment & Medical Supplies | 7154 W State St Ste 397, Boise, ID 83714-7421 | 2019-01-02 |
| 1467923789 | Amador Medical, LLC | Durable Medical Equipment & Medical Supplies | 963 S Orchard St Ste 203, Boise, ID 83705-1962 | 2018-12-14 |
| 1558840900 | Pure Vita Co. | Durable Medical Equipment & Medical Supplies | 4775 N Sunderland Ln, Boise, ID 83704-2216 | 2018-08-07 |
| 1922599067 | Idaho Sleep Specialists, PC | Durable Medical Equipment & Medical Supplies | 403 S 11th St Ste 210, Boise, ID 83702-6968 | 2018-05-24 |
| 1548784036 | Pacific Medical, Inc. | Durable Medical Equipment & Medical Supplies | 901 N Curtis Rd Ste 101, Boise, ID 83706-1339 | 2017-07-27 |
| 1386198141 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1276 W River St Ste 138, Boise, ID 83702-7066 | 2016-08-10 |
| 1164843272 | Everything Cpap, LLC | Durable Medical Equipment & Medical Supplies | 1166 N Cole Rd, Suite D, Boise, ID 83704-8658 | 2013-12-17 |
| 1073945887 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 3233 N Cole Rd, Boise, ID 83704-4402 | 2013-08-02 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on ID DEPT OF HEALTH & WELFARE CSHP (PKU FORM).
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.