Organization · Type 2 NPI
Southern Idaho Diabetes Education Program
Primary Care Clinic/Center · Shoshone, ID
NPI number
1154572311
Active
Practice location
108 NW Rail St
Shoshone, ID 83352
Fax (208) 886-2634
Mailing address
113 S Apple St
Shoshone, ID 83352-5287
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
About NPI 1154572311
Southern Idaho Diabetes Education Program's National Provider Identifier is 1154572311, issued on Oct 7, 2008. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Shoshone, ID. The record was last updated on Oct 7, 2008.