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Contact Information

INTERMOUNTAIN DIAGNOSTICS, INC.
200 N 4TH ST
SUITE 15
BOISE, ID83702-6001
 Phone: 208-331-0436
 Fax: 208-424-8501
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist/Technologist Cardiovascular, Sonography

246XS1301X
Indicates primary specialty

NPI Profile & details for INTERMOUNTAIN DIAGNOSTICS INC · (Female)

NPI # 1154429058
Status Active
Credentials
Entity Individual
Enumeration date 09/21/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID License # NONE GIVEN IN IDAHO
  • ID Other 8D244 BLUE CROSS
  • ID Other 000010017912 BLUE SHIELD
  • ID Other 170283 OMAP (OREGON MEDICAL)
  • ID Other 1538377 UNITED MINE WORKERS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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