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Contact Information

IDAHO INTERVENTIONAL PAIN CENTER
8950 W EMERALD
STE 164
BOISE, ID83704
 Phone: 208-323-6273
 Fax: 208-323-6277
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for IDAHO INTERVENTIONAL PAIN CENTER

NPI Number 1730140682
LBN Legal business name IDAHO INTERVENTIONAL PAIN CENTER
Authorized official RICHARD DUBOSE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/30/2006
Last updated 02/19/2008 - About 18 years ago
Identifiers n/a
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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