River Medical Family Medicine, PLLC
Family Medicine in Eagle, ID. Organization (NPI-2).
NPI number1194835546
StatusActive
Last updated in NPPESAug 1, 2011
Details
- NPI
- 1194835546
- Entity type
- Organization (NPI-2)
- Legal business name
- River Medical Family Medicine, PLLC
- Organization subpart
- No
- Enumeration date
- Aug 30, 2006
- Last updated
- Aug 1, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | M-8587 | ID | Yes |
Practice location
100 Cottonwood Ct Bldg DSuite 150
Eagle, ID 83616-6576
Phone 208-939-3314 · Fax 208-939-3315
Mailing address
Po Box 1909Eagle, ID 83616-9108
Phone 208-939-3314 · Fax 208-939-3315
Authorized official
Michael R. Minas
Physician
2089393314
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