Organization
URGENT CARE OF IDAHO, LLC
Active
Other names
Urgent Care of Jerome, Urgent Care of Jerome
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE JAMES (CO-OWNER)
(208) 678-6996
Entity
Organization
Contact information
Practice address
133 W AVENUE A, SUITE B, JEROME, ID 83338-2630
(208) 324-2004
(208) 324-1154
Mailing address
PO BOX 773, JEROME, ID 83338-5483
(208) 324-2004
(208) 324-1154
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
M-9766
ID
207Q00000X
Family Medicine Physician
O-154
ID
261QU0200X
Urgent Care Clinic/Center
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13D2082421
CLIA
ID
05
—
1538578687
—
ID
Enumeration date
08/02/2014
Last updated
05/24/2022
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