PRIMARY CARE SPECIALISTS, PA; NPI #1508875881

Contact Information

PRIMARY CARE SPECIALISTS, PA

110 VISTA DRIVE
POCATELLO, ID 83201

Phone: 208-234-2300
Fax: 208-234-0026
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for PRIMARY CARE SPECIALISTS, PA

NPI # 1508875881

LBN Legal business name PRIMARY CARE SPECIALISTS, PA

Authorized official MARK MANSFIELD - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/05/2006

Last updated 09/18/2012 - About 14 years ago

Identifiers

Medicaid

805105400

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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