Organization
HEALTHCARE WITH HEART LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD EUGENE CARROLL M.D. (OWNER)
(208) 989-0070
Entity
Organization
Contact information
Practice address
823 CENTER AVE, PAYETTE, ID 83661-2535
(208) 642-3396
(208) 642-9060
Mailing address
823 CENTER AVE, PAYETTE, ID 83661-2535
(208) 642-3396
(208) 642-9060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M4116
ID
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
N19189
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005775
REGENCE-REC
—
01
—
000010147752
REGENCE-LP
—
05
—
0036365
—
ID
05
—
231902
—
OR
05
—
278542
—
OR
01
—
73437
BLUE CROSS-REC
—
05
—
806957500
—
ID
01
—
8K818
BLUE CROSS-GROUP
—
01
—
D80174720
MEDICARE-RAILROAD
—
01
—
NPPU5
BLUE CROSS-LP
—
01
—
R108734
NORIDIAN
—
Enumeration date
05/23/2007
Last updated
06/14/2022
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