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General NPI Number Information
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NPI Number | 1821735945
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Entity Type | Organization
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Legal Business Name | URGENT CARE OF IDAHO, LLC
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Dates
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Enumeration Date | 05/19/2022
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1309 BLUE LAKES BLVD N
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City | TWIN FALLS
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State | ID
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Zip | 83301-3310
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Country | US
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Telephone | 208-933-4442
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Fax | 208-933-4273
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Provider Business Mailing Address
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Address Line | PO BOX 5809
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City | TWIN FALLS
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State | ID
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Zip | 83303-5809
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Country | US
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Telephone | 208-933-4442
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Fax | 208-933-4273
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Authorized Official
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Title or Position | CO-OWNER
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Name | KYLE JAMES
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Credential |
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Telephone | 208-324-2004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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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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