Organization
PURE HEALTHCARE OF IDAHO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL FRAGA (CONTRACTING MANAGER)
(801) 921-6325
Entity
Organization
Contact information
Practice address
5975 W OVERLAND RD, BOISE, ID 83709-3012
(208) 488-4998
(801) 327-0211
Mailing address
4179 S RIVERBOAT RD STE 220, TAYLORSVILLE, UT 84123-2986
(801) 755-3387
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2019
Last updated
05/06/2025
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