Organization
ROCKY MOUNTAIN DIABETES AND OSTEOPOROSIS CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET M HOOVER (BILLING LEAD)
(208) 522-2996
Entity
Organization
Contact information
Practice address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 522-2996
(208) 523-3318
Mailing address
3910 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7596
(208) 522-2996
(208) 523-3318
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
M4220
ID
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
M7763
ID
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
M9285
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42200
BLUE CROSS
—
01
—
804012300
HEALTHY CONNECTIONS
—
Enumeration date
10/18/2006
Last updated
07/27/2009
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