Organization · NPI-2

Alliance Medical Group, LLC

Family Medicine · Nampa, ID

NPI number1851730949
StatusActive
Last updated in NPPESFeb 17, 2025

Details

NPI
1851730949
Entity type
Organization (NPI-2)
Legal business name
Alliance Medical Group, LLC
Organization subpart
No
Enumeration date
Jun 21, 2013
Certification date
Feb 17, 2025
Last updated
Feb 17, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Other names

  • Primary Health Medical Group (Doing Business As)

Practice location

1115 12th Ave Rd
Nampa, ID 83686-5738

Phone 208-498-1080 · Fax 208-498-1081

Mailing address

Po Box 191050
Boise, ID 83719-1050

Phone 208-955-6500 · Fax 208-955-6501

Authorized official

Linda Barnes
Credentialing Mgr
2089851423

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