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1336526771 NPI number — QUIK-MED HEALTH CLINIC PLLC

NPI Number: 1336526771
Health Care Provider/Practitioner: QUIK-MED HEALTH CLINIC PLLC

Information about “1336526771” NPI (QUIK-MED HEALTH CLINIC PLLC) exists in 1336526771 in HTML format HTML  |  1336526771 in plain Text format TXT  |  1336526771 in PDF (Portable Document Format) PDF  |  1336526771 in an XML format XML  formats.

NPI Number : 1336526771 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336526771",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "QUIK-MED HEALTH CLINIC PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 567",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLARK FORK",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83811-0567",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-946-5100",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "104 E 4TH AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLARK FORK",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83811",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-946-5100",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/06/2015",
    "LastUpdateDate": "11/02/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GILLEY",
    "AuthorizedOfficialFirstName": "BETTY",
    "AuthorizedOfficialMiddleName": "ANNE",
    "AuthorizedOfficialTitle": "RN",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RN,MSM,FNP-C",
    "AuthorizedOfficialTelephoneNumber": "208-946-5100",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261Q00000X",
        "TaxonomyName": "Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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