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Contact Information

ADVANCED INTEGRATED MEDICAL CENTER
1395 NW MAIN ST
BLACKFOOT, ID83221-3936
 Phone: 208-785-0270
 Fax: 208-785-0683
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ADVANCED INTEGRATED MEDICAL CENTER

NPI # 1033674916
LBN Legal business name ADVANCED INTEGRATED MEDICAL CENTER
Authorized official DEE STEVENS - (OWNER/OPERATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/05/2019
Last updated 06/18/2020 - About 6 years ago
Identifiers
Other 1962456681 PERSONAL NPI
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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