National Provider Identifier Database

CLUB INC
Voluntary or Charitable


Contact Information

CLUB, INC.
2001 S WOODRUFF AVE
SUITE 6
IDAHO FALLS, ID83404-6374
Phone: 208-529-4673
Fax: 208-529-4676
Website:
Specialty Taxonomy Code
* Voluntary or Charitable 251V00000X

* Indicates primary specialty

NPI Profile & details for CLUB, INC.

NPI Number 1215097480
Legal business name
LBN
CLUB, INC.
Authorized official MARDEE HARPER - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 12/11/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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