Boise Vamc
Organization Active NPI VA Clinic/Center · Mountain Home, ID
NPI 1003223165 · NPPES record last updated Oct 31, 2017
Key facts
- NPI
- 1003223165
- Entity type
- Organization (NPI type 2)
- Primary specialty
- VA Clinic/Center 261QV0200X
- Legal business name
- BOISE VAMC
- Practice address
- 815 N 6TH E
Mountain Home, ID 83647-2207 - Phone
- (702) 341-3164
- NPI assigned
- Jul 21, 2014
- Organization subpart
- No
Authorized official
- Name
- Erin Potter
- Title
- Npi Team Member
- Phone
- (202) 382-2579
Corporate family (same tax ID) 9
National Provider Directory
- Tax ID family
- Boise Vamc
Locations
815 N 6th E
Mountain Home, ID 83647
Phone (208) 580-2001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| VA Clinic/Center | 261QV0200X | Yes |
Addresses
Primary practice location
815 N 6TH E
Mountain Home, ID 83647-2207
Mailing address
PO Box 94402
Cleveland, OH 44101-4402
Phone (702) 341-3164
Other names
- MOUNTAIN HOME VA CLINIC
Other providers in Mountain Home, ID
- Lester Barroso
- Dirk Kenneth Baskett
- Dawn D Best
- Brion Prince Bethel Sr.
- Tracy Lynn Bideganeta
- Shelby Bonello
- Josephine S Brown
- Anson C Call
- Melinda Carpenter
- Lee James Carter
All providers in Mountain Home, ID · VA Clinic/Center in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.