# OASIS MEDICAL CENTER LLC

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

## Provider details

- **NPI number:** 1699942854
- **Authorized official:** MR. JESSE MCMULLIN RT, DS (ADMINISTRATOR)
- **Authorized official phone:** (208) 286-6676

## Contact information

- **Practice address:** 9000 W DUCK LAKE DR, BOISE, ID 83714-1834
- **Practice address phone:** (208) 286-6676
- **Practice address fax:** (208) 672-8385
- **Mailing address:** 3217 W BAVARIA ST, EAGLE, ID 83616
- **Mailing address phone:** (208) 286-6676
- **Mailing address fax:** (208) 672-8385

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/15/2008
- **Last updated:** 05/15/2008