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NPI Code Detail

MEDICARE: ELITE MEDICINE PC

MEDICARE: ELITE MEDICINE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant
2363L00000XNurse Practitioner
3261QM1300XMulti-Specialty Clinic/Center

General Provider Information

NPI Number : 1487393393
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELITE MEDICINE PC
Provider Business Mailing Address
First Line : 1525 ADDISON AVE E STE A2
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-5300
Country : US
Telephone Number : 208-739-9961
Fax Number : 208-739-9962
Provider Business Practice Location Address
First Line : 1525 ADDISON AVE E STE A2
Second Line :
City : TWIN FALLS
State : ID
Zip : 83301-5300
Country : US
Telephone Number : 208-739-9961
Fax Number : 208-739-9962
Authorized Official
Title or Position : OWNER
Name : LINDSAY HUBSMITH
Credential : PA
Telephone Number : 208-358-3225
Provider Enumeration Date : 05/31/2022
Last Update Date : 12/20/2024

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Directions to “ELITE MEDICINE PC ” Practice Location

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