GEM FAMILY PRACTICE, INC; NPI #1205052198

Contact Information

GEM FAMILY PRACTICE, INC

1108 S WASHINGTON AVE
EMMETT, ID 83617-3535

Phone: 208-365-3455
Fax: 208-365-3422
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for GEM FAMILY PRACTICE, INC

NPI # 1205052198

LBN Legal business name GEM FAMILY PRACTICE, INC

Authorized official JENNICE CORDOVA - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 04/18/2007

Last updated 08/22/2020 - About 6 years ago

Identifiers

License #

PA 281

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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