Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
BOISE INTENSIVE CARE HOSPITAL INC
Active
Organization
BOISE INTENSIVE CARE HOSPITAL INC
Active
Other names
Complex Care Hosptial of Idaho
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MICHAEL CRONIN (VICE PRESIDENT)
(469) 241-2128
Entity
Organization
Contact information
Practice address
2131 S BONITO WAY, MERIDIAN, ID 83642-1659
(877) 801-2244
(208) 489-9599
Mailing address
5340 LEGACY DR, SUITE 150, PLANO, TX 75024-3178
(469) 241-2100
(469) 241-2177
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
69
ID
282E00000X
Long Term Care Hospital
Primary
69
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1369006
MEDICARE - B
ID
05
—
808282500
—
ID
Enumeration date
12/04/2008
Last updated
01/07/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up