Organization
SUPERIOR VEIN CARE, PLLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZUL COHLMIA (CHIEF OPERATING OFFICER)
(208) 600-1550
Entity
Organization
Contact information
Practice address
3277 E LOUISE DR STE 360, MERIDIAN, ID 83642-9359
(208) 600-1550
(208) 600-1551
Mailing address
3875 E OVERLAND RD STE 2D, MERIDIAN, ID 83642-9005
(208) 484-2431
(866) 335-0887
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
11/26/2018
Last updated
05/14/2024
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