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Contact Information

BLUE LAKES MEDICINE PA
1122 EASTLAND DR N
STE 2
TWIN FALLS, ID83301-8444
 Phone: 208-734-9531
 Fax: 208-733-6969
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for BLUE LAKES MEDICINE PA

NPI Number 1063872489
LBN Legal business name BLUE LAKES MEDICINE PA
Authorized official HOWARD ARRINGTON - (PROVIDER / OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/26/2016
Last updated 02/26/2016 - About 10 years ago
Identifiers
ID License # NP-1688A
ID Other 1374328 MEDICARE PTAN
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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