Organization · NPI-2

Ageless Women'S Health Id LLC

Family Medicine, Adult Medicine · Meridian, ID

NPI number1235975202
StatusActive
Last updated in NPPESJul 8, 2024

Details

NPI
1235975202
Entity type
Organization (NPI-2)
Legal business name
Ageless Women'S Health Id LLC
Organization subpart
No
Enumeration date
Jul 8, 2024
Certification date
Jul 8, 2024
Last updated
Jul 8, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207QA0505X Family Medicine, Adult Medicine––Yes

Practice location

3875 E Overland Rd Ste 108
Meridian, ID 83642-9047

Phone 208-268-5592

Mailing address

3875 E Overland Rd Ste 108
Meridian, ID 83642-9047

Authorized official

Teah Phillips
Credentialing Manager
9012053999

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