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General NPI Number Information
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NPI Number | 1043722259
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Entity Type | Organization
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Legal Business Name | JUST 4 KIDS HEALTH LLC
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Dates
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Enumeration Date | 10/27/2017
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 3320 S 25TH E
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City | IDAHO FALLS
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State | ID
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Zip | 83404-4606
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Country | US
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Telephone | 208-656-1500
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Fax | 208-656-1502
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Provider Business Mailing Address
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Address Line | PO BOX 1407
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City | IDAHO FALLS
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State | ID
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Zip | 83403-1407
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Country | US
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Telephone | 208-656-7396
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AARON GARDNER
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Credential | MD
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Telephone | 208-656-7396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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