Ageless Women'S Health Id LLC
Organization Active NPI Adult Medicine Physician · Meridian, ID
NPI 1235975202 · NPPES record last updated Jul 8, 2024
Key facts
- NPI
- 1235975202
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- Legal business name
- AGELESS WOMEN'S HEALTH ID LLC
- Practice address
- 3875 E Overland Rd Ste 108
Meridian, ID 83642-9047 - Phone
- (208) 268-5592
- NPI assigned
- Jul 8, 2024
- Organization subpart
- No
Authorized official
- Name
- Teah Phillips
- Title
- Credentialing Manager
- Phone
- (901) 205-3999
National Provider Directory
Locations
3875 E Overland Rd
Ste 108
Meridian, ID 83642
Phone (208) 297-5829
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician |
207QA0505X | Yes |
Addresses
Primary practice location
3875 E Overland Rd Ste 108
Meridian, ID 83642-9047
Mailing address
3875 E Overland Rd Ste 108
Meridian, ID 83642-9047
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All providers in Meridian, ID · Adult Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2024. 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.