Organization · NPI-2

Amh Series II Id, LLC

Family Medicine · Eagle, ID

NPI number1649925389
StatusActive
Last updated in NPPESNov 11, 2024

Details

NPI
1649925389
Entity type
Organization (NPI-2)
Legal business name
Amh Series II Id, LLC
Organization subpart
No
Enumeration date
Feb 21, 2022
Certification date
Nov 11, 2024
Last updated
Nov 11, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Other names

  • Ageless Men'S Health (Doing Business As)

Practice location

1545 E Iron Eagle Dr Ste 101
Eagle, ID 83616-7079

Phone 208-906-9128

Mailing address

1545 E Iron Eagle Dr Ste 101
Eagle, ID 83616-7079

Authorized official

Amanda Wilkinson
Business Operations Director
7028180446

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