Organization
LEGACY PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL FISH (OWNER)
(208) 570-2707
Entity
Organization
Contact information
Practice address
2667 E GALA CT STE 100, MERIDIAN, ID 83642-2792
(208) 570-2707
Mailing address
2273 E GALA ST STE 120, MERIDIAN, ID 83642-7289
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
09/24/2024
Last updated
10/16/2024
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