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General NPI Number Information
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NPI Number | 1114845526
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Entity Type | Organization
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Legal Business Name | 5 CODES PC
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 1831 N LAKEWOOD DR STE 1
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2669
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Country | US
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Telephone | 208-215-7199
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Fax | 208-215-7199
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Provider Business Mailing Address
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Address Line | 1831 N LAKEWOOD DR STE 1
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2669
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Country | US
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Telephone | 208-215-7199
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Fax | 208-215-7199
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | STACEY HEIDT
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Credential |
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Telephone | 509-998-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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