Pivot Health LLC
General Practice in Meridian, ID. Organization (NPI-2).
NPI number1417535329
StatusActive
Last updated in NPPESMar 31, 2021
Details
- NPI
- 1417535329
- Entity type
- Organization (NPI-2)
- Legal business name
- Pivot Health LLC
- Organization subpart
- No
- Enumeration date
- Mar 31, 2021
- Certification date
- Mar 31, 2021
- Last updated
- Mar 31, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
808 S Vanguard WayMeridian, ID 83642-7552
Phone 208-817-2008
Mailing address
Po Box 44595Boise, ID 83711-0595
Other practice locations
1290 W Myrtle St Ste 190
Boise, ID 83702-6945
Boise, ID 83702-6945
Phone 208-616-1161
Authorized official
John Thomas Ahlquist
Owner, MD
2086161050
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