Provider Demographics
NPI:1043857717
Name:AARON J ADAMS
Entity Type:Organization
Organization Name:AARON J ADAMS
Other - Org Name:COMPLETE HOME AND PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEE ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-936-8206
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:RUPERT
Mailing Address - State:ID
Mailing Address - Zip Code:83350-0271
Mailing Address - Country:US
Mailing Address - Phone:208-936-8206
Mailing Address - Fax:
Practice Address - Street 1:7885 S 2530 E
Practice Address - Street 2:
Practice Address - City:SOUTH WEBER
Practice Address - State:UT
Practice Address - Zip Code:84405-9269
Practice Address - Country:US
Practice Address - Phone:801-949-0388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
197929728863OtherINDIVIDUAL NPI