Idaho Street Medical Clinic
Organization Active NPI Health Service Clinic/Center · Homedale, ID
NPI 1023639622 · NPPES record last updated May 5, 2020
Key facts
- NPI
- 1023639622
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- Legal business name
- IDAHO STREET MEDICAL CLINIC
- Practice address
- 126 W. Idaho Ave
Homedale, ID 83628-8362 - Phone
- (208) 337-7038
- Fax
- (208) 337-4652
- NPI assigned
- May 5, 2020
- Organization subpart
- No
Authorized official
- Name
- Edith Mary Roe, NP-BC
- Title
- Nurse Practitioner
- Phone
- (208) 859-4103
Practitioners 1
-
Edith Mary Roe, NP-BC
National Provider Directory
Interoperability endpoints
- bestmedicalcare@outloo.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Yes |
Addresses
Primary practice location
126 W. Idaho Ave
Homedale, ID 83628-8362
Mailing address
24900 Market Rd
Parma, ID 83660-6723
Phone (208) 722-7744
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | BestMedicalcare@outloo.com | Health Information Exchange (HIE) |
Other providers in Homedale, ID
- Stacy Carol Fisher
- Homedale Healthcare, Inc.
- Homedale Rural Fire Protection District
- Brett J Homstad
- Idaho Frontier Wellness
- Idaho Street Medical Clinic
- Identistry PLLC
- William Guy Jeppe Jr.
- Jenifer Kitchens
- Jared Martin
All providers in Homedale, ID · Health Service 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 May 5, 2020. 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.