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Organization
OASIS MEDICAL CENTER LLC
Active
Organization
OASIS MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE MCMULLIN RT, DS (ADMINISTRATOR)
(208) 286-6676
Entity
Organization
Contact information
Practice address
9000 W DUCK LAKE DR, BOISE, ID 83714-1834
(208) 286-6676
(208) 672-8385
Mailing address
3217 W BAVARIA ST, EAGLE, ID 83616
(208) 286-6676
(208) 672-8385
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
NULL
261QU0200X
Urgent Care Clinic/Center
Primary
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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