Organization · NPI-2

Align Integrated Medical LLC

Family Medicine · Meridian, ID

NPI number1619484102
StatusActive
Last updated in NPPESJul 7, 2020

Details

NPI
1619484102
Entity type
Organization (NPI-2)
Legal business name
Align Integrated Medical LLC
Organization subpart
No
Enumeration date
Jan 5, 2018
Certification date
Jul 7, 2020
Last updated
Jul 7, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
332B00000X Durable Medical Equipment & Medical Supplies––

Practice location

750 W Ustick Rd Ste 100
Meridian, ID 83646

Phone 208-639-1397

Mailing address

750 W Ustick Rd Ste 100
Meridian, ID 83646-6133

Phone 208-639-1397

Authorized official

Chad Woolner
Ceo
2086391397

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