Organization
SOUTH HILL SUBOXONE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMIL SIDHU MD (OWNER)
(866) 805-0885
Entity
Organization
Contact information
Practice address
1103 E BEST AVE, STE C, COEUR D ALENE, ID 83814-4878
(866) 805-0885
Mailing address
PO BOX 3727, COEUR D ALENE, ID 83816-2529
(866) 805-0885
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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