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NPI Code Detail

MEDICARE: PUBLIC HEALTH DISTRICT 1

MEDICARE: PUBLIC HEALTH DISTRICT 1
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian
2174H00000XHealth Educator
3261QP0905XState or Local Public Health Clinic/Center

General Provider Information

NPI Number : 1427616846
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUBLIC HEALTH DISTRICT 1
Provider Business Mailing Address
First Line : 8500 NORTH ATLAS ROAD
Second Line :
City : HAYDEN
State : ID
Zip : 83835-8332
Country : US
Telephone Number : 208-415-5100
Fax Number : 208-415-5101
Provider Business Practice Location Address
First Line : 8500 NORTH ATLAS ROAD
Second Line :
City : HAYDEN
State : ID
Zip : 83835-8332
Country : US
Telephone Number : 208-415-5100
Fax Number : 208-415-5101
Authorized Official
Title or Position : DIRECTOR
Name : MR. DONALD DUFFY
Credential :
Telephone Number : 205-415-5163
Provider Enumeration Date : 05/31/2019
Last Update Date : 03/16/2022

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Directions to “PUBLIC HEALTH DISTRICT 1 ” Practice Location

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