Organization
COMMUNITY CARE CHANNING WAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN ROSSI VICE PRESIDENT (PATIENT FINANCIAL SERVICES)
(208) 557-2716
Entity
Organization
Contact information
Practice address
2725 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 525-8448
(208) 525-8118
Mailing address
2725 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 525-8448
(208) 525-8118
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
W 110635
ID
Other
Enumeration date
02/29/2012
Last updated
02/29/2012
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