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General NPI Number Information
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NPI Number | 1972466654
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Entity Type | Organization
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Legal Business Name | COEUR THERAPEUTICS JJ
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 110 E WALLACE AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2948
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Country | US
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Telephone | 208-450-5184
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Fax |
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Provider Business Mailing Address
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Address Line | 6648 N DAVENPORT ST
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City | DALTON GARDENS
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State | ID
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Zip | 83815-9566
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA JAMESON
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Credential | MD
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Telephone | 208-450-5184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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