NPIMap

Organization Active NPI

Clearwater Vein Care Center PC

  • Specialist
  • Lewiston, ID
National Provider Identifier
1174693196
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00045914 Issued in ID
Legal business name
CLEARWATER VEIN CARE CENTER PC
Practice address
3316 1/2 4TH St
Suite 4B
Lewiston, ID 83501-4460
Phone
(208) 798-7600
Fax
(208) 798-7602
NPI assigned
Nov 8, 2006
Last updated
Dec 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Authorized official

Name
Alan G Muench, MDNPI 1679661136
Title
President
Phone
(208) 798-7600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD00045914 ID Primary

Addresses

Primary practice location

3316 1/2 4TH St
Suite 4B
Lewiston, ID 83501-4460

Mailing address

3316 1/2 4TH St
Suite 4B
Lewiston, ID 83501-4460
Phone (208) 798-7600

National Provider Directory

National Provider Directory

Locations

1630 23rd Ave
Ste 1001A
Lewiston, ID 83501
Phone (208) 798-7600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229385600000",
    "number": "1174693196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 1/2 4TH ST",
            "address_2": "SUITE 4B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014460",
            "telephone_number": "208-798-7600",
            "fax_number": "208-798-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 1/2 4TH ST",
            "address_2": "SUITE 4B",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014460",
            "telephone_number": "208-798-7600",
            "fax_number": "208-798-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER VEIN CARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-12-16",
        "status": "A",
        "authorized_official_last_name": "MUENCH",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-798-7600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ID",
            "license": "MD00045914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; 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.