Provider Demographics
NPI:1093446718
Name:PARAGOND LLC
Entity Type:Organization
Organization Name:PARAGOND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:208-789-0220
Mailing Address - Street 1:3715 E OVERLAND RD STE 120
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-8301
Mailing Address - Country:US
Mailing Address - Phone:087-890-2202
Mailing Address - Fax:205-789-0047
Practice Address - Street 1:3715 E OVERLAND RD STE 120
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-8301
Practice Address - Country:US
Practice Address - Phone:208-789-0220
Practice Address - Fax:208-789-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty