Organization · NPI-2

Aaa American Healthcare LLC

General Practice · Idaho Falls, ID

NPI number1912378787
StatusActive
Last updated in NPPESOct 19, 2015

Details

NPI
1912378787
Entity type
Organization (NPI-2)
Legal business name
Aaa American Healthcare LLC
Organization subpart
No
Enumeration date
Oct 19, 2015
Last updated
Oct 19, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General PracticeM4260IDYes
363L00000X Nurse PractitionerNP 1389AID

Practice location

1301 E 17th St Ste 5
Idaho Falls, ID 83404-6273

Phone 208-538-3122

Mailing address

1301 E 17th St Ste 5
Idaho Falls, ID 83404-6273

Phone 208-538-3122

Authorized official

Alban Hatch
Manager
2082003000

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