Healthcare Provider Details

I. General information

NPI: 1275215998
Provider Name (Legal Business Name): BADGER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 SCIENCE CENTER DR
IDAHO FALLS ID
83402-1506
US

IV. Provider business mailing address

PO BOX 2106
IDAHO FALLS ID
83403-2106
US

V. Phone/Fax

Practice location:
  • Phone: 208-826-0994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEMI ECHI-ABOLI
Title or Position: BILLING DEPARTMENT DIRECTOR
Credential:
Phone: 208-360-1038