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Organization
BOISE INTENSIVE CARE HOSPITAL, INC.
Active
Organization
BOISE INTENSIVE CARE HOSPITAL, INC.
Active
Other names
Complex Care Hospital of Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL CRONIN CPA (VICE PRESIDENT OF REIMBURSEMENT)
(469) 241-2128
Entity
Organization
Contact information
Practice address
2131 SOUTH BONITO WAY, MERIDIAN, ID 83642-1659
(866) 599-9925
Mailing address
5340 LEGACY DR, SUITE 150, PLANO, TX 75024-3178
(469) 241-2100
(469) 241-5199
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1369006
MEDICARE - PART B
ID
Enumeration date
12/13/2007
Last updated
03/07/2012
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