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Contact Information

THE PEDIATRIC AND ADOLESCENT CENTER, INC.
6148 N DISCOVERY WAY
SUITE 100
BOISE, ID83713-0201
 Phone: 208-322-5437
 Fax: 208-322-6013
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for THE PEDIATRIC AND ADOLESCENT CENTER, INC.

NPI Number 1144341637
LBN Legal business name THE PEDIATRIC AND ADOLESCENT CENTER, INC.
Authorized official WILLIAM BOURQUARD - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/02/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
ID License # M-5223
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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