Organization
HEROIC DIABETES INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAREN SMITH RN, BSN (PRESIDENT)
(208) 821-4136
Entity
Organization
Contact information
Practice address
4214 N AMBERCREEK AVE, MERIDIAN, ID 83646-7019
(208) 821-4136
Mailing address
1302 MEADOWVIEW AVE, REXBURG, ID 83440-5079
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2025
Last updated
03/16/2026
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