Organization
SANDCREEK ECHO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CARPENTER RDCS,RVT (PRESIDENT)
(208) 529-2561
Entity
Organization
Contact information
Practice address
2050 E 25TH ST, IDAHO FALLS, ID 83404-6490
(208) 529-2561
(208) 529-2568
Mailing address
2050 E 25TH ST, IDAHO FALLS, ID 83404-6490
(208) 529-2561
(208) 529-2568
Taxonomy
Speciality
Code
Description
License number
State
246XS1301X
Sonography Specialist/Technologist Cardiovascular
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010029412
BLUE SHIELD
ID
01
—
8D780
BLUE CROSS
ID
Enumeration date
01/18/2006
Last updated
08/22/2020
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