Snake River Pediatrics, Pc

LBN: Snake River Pediatrics, Pc
Snake River Pediatrics, Pc is an health care organization with primary practice located at 1100 Nw 12Th St , Fruitland ID 83619-5040. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Rural Health. Ambulatory Health Care Facilities / Rural Health is the primary health care specialty. Snake River Pediatrics, Pc can be contacted via phone (208) 452-6556, or through Berria, Matthew Joseph via phone (208) 740-4518.

Contact Information

Primary practice address
1100 Nw 12Th St Fruitland ID 83619-5040
Phone: (208) 452-6556
Fax: (541) 216-6557
Website:
Map and Directions
Authorized official contact:
Name: Berria, Matthew Joseph PHD, PA-C
Phone: (208) 740-4518

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X PA000913 Oregon
Ambulatory Health Care Facilities / Rural Health 261QR1300X PA000913 Oregon

Profile Details

NPI number 1700269792
LBN Legal business name Snake River Pediatrics, Pc
DBA Doing business as
Authorized official Berria, Matthew Joseph PHD, PA-C
Entity Organization
Organization subpart 1 No
Enumeration date Jul 8th, 2015
Last updated Aug 16th, 2023 - about 3 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 1700269792 NPPES
Oregon MEDICAID 500605243
Oregon Other 1902985740

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