NPIMap

Organization Active NPI

Eagle Healthcare LLC

  • Community Based Hospice Care Agency
  • Eagle, ID
National Provider Identifier
1275224966
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
EAGLE HEALTHCARE LLC
Practice address
1675 E Riverside Dr Ste 200
Eagle, ID 83616-7473
Phone
(208) 401-1369
NPI assigned
May 15, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Lee Johnson
Title
Treasurer
Phone
(208) 401-1369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1675 E Riverside Dr Ste 200
Eagle, ID 83616-7473

Mailing address

1675 E Riverside Dr Ste 200
Eagle, ID 83616-7473
Phone (208) 401-1369

National Provider Directory

National Provider Directory
Tax ID family
Eagle Healthcare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1275224966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 E RIVERSIDE DR STE 200",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167473",
            "telephone_number": "208-401-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E RIVERSIDE DR STE 200",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167473",
            "telephone_number": "208-401-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "208-401-1369"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.