# FAMILY MEDICAL CARE CLINICS CORPORATION A PROFESSIONAL ASSOCIATION

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

## Provider details

- **NPI number:** 1942730775
- **Authorized official:** JOHN L TORQUATO MD (PRESIDENT)
- **Authorized official phone:** (208) 772-7850

## Contact information

- **Practice address:** 265 W PRAIRIE SHOPPING CTR, HAYDEN, ID 83835-9855
- **Practice address phone:** (208) 772-7850
- **Practice address fax:** (208) 772-2313
- **Mailing address:** PO BOX 38, HAYDEN, ID 83835-0038
- **Mailing address phone:** (208) 772-7850
- **Mailing address fax:** (208) 772-2313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/14/2017
- **Last updated:** 03/17/2018