Organization
PHYSICIANS CLINIC PLLC
Active
Other names
STATE STREET IMMEDIATE MEDICAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CORINNE K CHASTAIN (OFFICE MANAGER)
(208) 375-0500
Entity
Organization
Contact information
Practice address
4902 W STATE ST, BOISE, ID 83703-3326
(208) 853-3100
(208) 853-3120
Mailing address
4902 W STATE ST, BOISE, ID 83703-3326
(208) 853-3100
(208) 853-3120
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8M400
BLUE CROSS
ID
Enumeration date
10/13/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us