Eagle Health Services LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

EAGLE HEALTH SERVICES LLC

Doing business as

Bridge Dialysis of Idaho

Practice address

1351 W Pine Ave Ste B
Meridian, ID 83642-2010

Phone

(385) 420-7500

NPI assigned

Feb 4, 2025

Last updated

Feb 4, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tangina Maloof

Title

Treasurer

Phone

(469) 636-5055

Specialties & licenses 1

Addresses

Other names 1

• Bridge Dialysis of Idaho Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1114731882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 FLINT MEADOW DR STE 1C",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840376833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 W PINE AVE STE B",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422010",
            "telephone_number": "385-420-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "MALOOF",
        "authorized_official_first_name": "TANGINA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "469-636-5055"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridge Dialysis of Idaho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.