State Of Idaho in Blackfoot - Clinical Medical Laboratory
State Of Idaho - NPI 1790841781
State Of Idaho is a Clinical Medical Laboratory in Blackfoot, Idaho. State Of Idaho practices all healthcare services and medical treatments related to Clinical Medical Laboratory. The NPI Number for State Of Idaho is 1790841781. The last update date is 2020-08-22.
State Of Idaho's current location address is Box 400, Blackfoot, Idaho. You can contact this provider via phone number 2087858429 and fax number 2087858439. The mailing address for State Of Idaho is Box 400, Blackfoot, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | State Of Idaho |
|---|---|
| Address | Box 400, Blackfoot, Idaho |
| Phone Number | 2087858429 |
| Fax Number | 2087858439 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Heckard Duane Ralph |
| Credentials | M.D. |
| Telephone Number | 2087858429 |
NPI Number Detail
| NPI Number | 1790841781 |
|---|---|
| Provider Enumeration Date | 2006-12-28 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | Box 400 |
|---|---|
| City | Blackfoot |
| State | Idaho (ID) |
| Post Code | 83221 |
| Phone Number | 2087858429 |
| Fax Number | 2087858439 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Medical Laboratory |
|---|---|
| Taxonomy | 291U00000X |
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Definition: (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purp |
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What is the unique 10-digit identification code assigned to State Of Idaho by the Centers for Medicare & Medicaid Services?
The State Of Idaho has been issued the NPI (National Provider Identifier) 1790841781, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where State Of Idaho is geographically located?
The State Of Idaho is physically situated at the following location: Box 400, Blackfoot, ID, 83221.
What is State Of Idaho's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for State Of Idaho is Clinical Medical Laboratory, and the taxonomy classification code that categorizes this area of expertise is 291U00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1790841781 to State Of Idaho?
The Centers for Medicare & Medicaid Services originally issued the 1790841781 to State Of Idaho on 2006-12-28.
When was the information related to State Of Idaho most recently updated or refreshed?
The details pertaining to the State Of Idaho, including its address, specialty, and other relevant information, were last updated or refreshed on 2020-08-22.
NPI Number: 1962405878
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