Star Medical Center Pc

LBN: Star Medical Center Pc
Star Medical Center Pc is an health care organization with primary practice located at 9858 W State St , Star ID 83669-5210. The organization recently has only one registered license in Nursing Service Providers / General Practice, which is considered as the primary health care specialty. Star Medical Center Pc can be contacted via phone (208) 286-0666, or through Dodge, Elmer G via phone (208) 286-0666.

Contact Information

Primary practice address
9858 W State St Star ID 83669-5210
Phone: (208) 286-0666
Fax: (208) 286-0565
Website:
Map and Directions
Authorized official contact:
Name: Dodge, Elmer G Registered Nurse Practitioner (RNP)
Phone: (208) 286-0666

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X

Profile Details

NPI number 1508918244
LBN Legal business name Star Medical Center Pc
DBA Doing business as
Authorized official Dodge, Elmer G Registered Nurse Practitioner (RNP)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 16th, 2007
Last updated May 14th, 2013 - about 13 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 1508918244 NPPES
Idaho Other 8L030 BLUE CROSS OF ID
Idaho MEDICAID 807071100 BLUE CROSS OF ID

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