National Provider Identifier Database

CENTER STREET HEALTH CARE LLC
Family


Contact Information

CENTER STREET HEALTH CARE LLC
1553 E CENTER ST
POCATELLO, ID83201-4135
Phone: 208-233-9355
Fax: 208-233-9300
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for CENTER STREET HEALTH CARE LLC

NPI Number 1417104530
Legal business name
LBN
CENTER STREET HEALTH CARE LLC
Authorized official CYNTHIA RICE - (OWNER/PROVIDER)
Entity Organization
Organization subpart No
Enumeration date 08/20/2008
Last updated 09/30/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: NP252A
  • ID Medicaid: 004383300

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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