# NORTH IDAHO NEPHROLOGY ASSOCIATES, INC.

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

## Provider details

- **NPI number:** 1912181090
- **Authorized official:** SHAUN K. JOSHI M.D. (OWNER)
- **Authorized official phone:** (208) 762-7760

## Contact information

- **Practice address:** 1986 W HAYDEN AVE STE C, HAYDEN, ID 83835-7412
- **Practice address phone:** (208) 762-7760
- **Practice address fax:** (208) 762-7740
- **Mailing address:** 1986 W HAYDEN AVE STE C, HAYDEN, ID 83835-7412
- **Mailing address phone:** (208) 762-7760
- **Mailing address fax:** (208) 762-7740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/24/2007
- **Last updated:** 07/15/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010166370 | REGENCE BLUE SHIELD | ID |
| 05 | — | 808003600 | — | ID |
| 05 | — | 8239220 | — | WA |
| 01 | — | 8N389 | BLUE CROSS OF IDAHO | ID |