Mountain Pine Dermatology, Pllc

LBN: Mountain Pine Dermatology, Pllc
Mountain Pine Dermatology, Pllc is an health care organization with primary practice located at 4664 N Penngrove Way Ste 100 , Meridian ID 83646-7442. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Mountain Pine Dermatology, Pllc can be contacted via phone (208) 898-7467, or through Thomas, Richard Scott via phone (208) 250-7433.

Contact Information

Primary practice address
4664 N Penngrove Way Ste 100 Meridian ID 83646-7442
Phone: (208) 898-7467
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Thomas, Richard Scott Doctor of Osteopathy (DO)
Phone: (208) 250-7433

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X O-0934 Idaho

Profile Details

NPI number 1659827665
LBN Legal business name Mountain Pine Dermatology, Pllc
DBA Doing business as
Authorized official Thomas, Richard Scott Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2016
Last updated Jul 5th, 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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