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Contact Information

PATHOLOGY ASSOCIATES OF IDAHO FALLS P A
3100 CHANNING WAY
IDAHO FALLS, ID83404-7533
 Phone: 208-529-6050
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for PATHOLOGY ASSOCIATES OF IDAHO FALLS P A

NPI Number 1497723241
LBN Legal business name PATHOLOGY ASSOCIATES OF IDAHO FALLS P A
Authorized official MATT TANNENBAUM - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/09/2006
Last updated 03/06/2020 - About 6 years ago
Identifiers
ID Medicaid 002346700
ID Other 88971 BLUE CROSS OF ID
ID Other 000010026929 REGENCE BLUE SHIELD ID
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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