Susan E Tomey
OLDE TOWN MEDICAL


Address: 124 E Pine Ave, Meridian, ID 83642-2331
Phone: 2082879420

Susan E Tomey (NPI# 1063506616, PAC ID# 2062501646) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.

Physician Overview

Nation Provider ID (NPI) 1063506616
PAC ID by PECOS 2062501646
Professional Enrollment ID I20071204000850
Full Name Susan E Tomey
Organization Legal Name OLDE TOWN MEDICAL
Address 124 E Pine Ave
Meridian
ID 83642-2331
Phone Number 2082879420
Gender F
Graduation Year 2004
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 6709184567
Number of Group Practice Members 2
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
130006 ST LUKE'S REGIONAL MEDICAL CENTER

Other Locations

Address Phone Organization
124 E Pine Ave, Meridian, ID 83642-2331 2082879420 OLDE TOWN MEDICAL

Organization Information

Organization Legal Name OLDE TOWN MEDICAL
Physicians 1

Office Location

Street Address 124 E PINE AVE
City MERIDIAN
State ID
Zip 83642-2331

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Competitor

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City MERIDIAN
Zip Code 83642
Specialty NURSE PRACTITIONER
City + Specialty MERIDIAN + NURSE PRACTITIONER

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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