Organization
GEM FAMILY PRACTICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNICE M CORDOVA MPA-C (PRESIDENT)
(208) 365-3455
Entity
Organization
Contact information
Practice address
1108 S WASHINGTON AVE, EMMETT, ID 83617-3535
(208) 365-3455
(208) 365-3422
Mailing address
1108 S WASHINGTON AVE, EMMETT, ID 83617-3535
(208) 365-3455
(208) 365-3422
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
PA 281
ID
Other
Enumeration date
04/18/2007
Last updated
08/22/2020
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