# RIVER MEDICAL FAMILY MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194835546
- **Authorized official:** MICHAEL R. MINAS MD (PHYSICIAN)
- **Authorized official phone:** (208) 939-3314

## Contact information

- **Practice address:** 100 COTTONWOOD CT BLDG D, SUITE 150, EAGLE, ID 83616-6576
- **Practice address phone:** (208) 939-3314
- **Practice address fax:** (208) 939-3315
- **Mailing address:** PO BOX 1909, EAGLE, ID 83616-9108
- **Mailing address phone:** (208) 939-3314
- **Mailing address fax:** (208) 939-3315

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | M-8587 | ID | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/01/2011