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General NPI Number Information
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NPI Number | 1912221318
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Entity Type | Organization
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Legal Business Name | UNITY HEALTH CENTER PLLC
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Dates
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Enumeration Date | 03/15/2010
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Last Update Date | 03/17/2021
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Provider Practice Location Address
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Address Line | 1130 E FAIRVIEW AVE
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City | MERIDIAN
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State | ID
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Zip | 83642-1813
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Country | US
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Telephone | 208-895-6729
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Fax | 208-855-5921
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Provider Business Mailing Address
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Address Line | PO BOX 314
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City | MERIDIAN
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State | ID
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Zip | 83680-0314
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Country | US
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Telephone | 208-895-6729
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Fax | 208-855-5921
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEITH RUSSELL SWAINSTON
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Credential | DNP
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Telephone | 208-895-6729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine 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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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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