Eagle Crest Life Services in Coeur D Alene - Prescribing (medical)
Eagle Crest Life Services - NPI 1659572493
Eagle Crest Life Services is a Prescribing (medical) in Coeur D Alene, Idaho. Eagle Crest Life Services practices all healthcare services and medical treatments related to Prescribing (medical). The NPI Number for Eagle Crest Life Services is 1659572493. The last update date is 2020-08-22.
Eagle Crest Life Services's current location address is 416 E Coeur Dalene Ave, Coeur D Alene, Idaho. You can contact this provider via phone number 2086669162. The mailing address for Eagle Crest Life Services is 416 E Coeur Dalene Ave, Coeur D Alene, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Eagle Crest Life Services |
|---|---|
| Address | 416 E Coeur Dalene Ave, Coeur D Alene, Idaho |
| Phone Number | 2086669162 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Wheeler Robert |
| Telephone Number | 2086669162 |
NPI Number Detail
| NPI Number | 1659572493 |
|---|---|
| Provider Enumeration Date | 2007-05-30 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 416 E Coeur Dalene Ave |
|---|---|
| City | Coeur D Alene |
| State | Idaho (ID) |
| Post Code | 838142825 |
| Phone Number | 2086669162 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Prescribing (medical) |
|---|---|
| Taxonomy | 103Tp0016X |
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Definition: A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establis |
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What is the unique 10-digit identifier code assigned to Eagle Crest Life Services by the Centers for Medicare & Medicaid Services?
The Eagle Crest Life Services has been issued the NPI (National Provider Identifier) 1659572493 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Eagle Crest Life Services's facilities are geographically located?
The facilities of Eagle Crest Life Services are physically situated at the following location: 416 E Coeur Dalene Ave, Coeur D Alene, ID, 838142825.
What is Eagle Crest Life Services's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Eagle Crest Life Services's specialized field of practice is Prescribing (medical), and the corresponding taxonomy code that categorizes this area of specialization is 103Tp0016X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1659572493 to Eagle Crest Life Services?
The Centers for Medicare & Medicaid Services originally issued the 1659572493 to Eagle Crest Life Services on 2007-05-30.
As of what date were the details related to Eagle Crest Life Services most recently updated or revised?
The information pertaining to Eagle Crest Life Services, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.