Gem State Pediatrics

LBN: Gem State Pediatrics
Gem State Pediatrics is an health care organization with primary practice located at 520 S Eagle Rd Suite 1209, Meridian ID 83642-6308. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Gem State Pediatrics can be contacted via phone (208) 706-5460, or through Brus, Mario via phone (208) 706-5460.

Contact Information

Primary practice address
520 S Eagle Rd Suite 1209 Meridian ID 83642-6308
Phone: (208) 706-5460
Fax: (208) 706-5465
Website:
Map and Directions
Authorized official contact:
Name: Brus, Mario Doctor of Medicine (MD)
Phone: (208) 706-5460

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M5562 Idaho

Profile Details

NPI number 1992853386
LBN Legal business name Gem State Pediatrics
DBA Doing business as
Authorized official Brus, Mario Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 8th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992853386 NPPES
Idaho Other 57885 BLUE CROSS OF IDAHO
Idaho Other 000010001341 BLUE CROSS OF IDAHO

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