Provider Demographics
NPI:1609885870
Name:N S SUPPORT LLC
Entity Type:Organization
Organization Name:N S SUPPORT LLC
Other - Org Name:NEUROSCIENCE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:REDIKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-327-5631
Mailing Address - Street 1:6140 W CURTISIAN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8907
Mailing Address - Country:US
Mailing Address - Phone:208-327-5600
Mailing Address - Fax:208-327-5602
Practice Address - Street 1:6140 W CURTISIAN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704
Practice Address - Country:US
Practice Address - Phone:208-367-3500
Practice Address - Fax:208-367-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
006153OtherDMAP
ID8J190OtherBLUE CROSS OF IDAHO GROUP
ID8J190OtherBLUE CROSS OF IDAHO GROUP
1375211Medicare PIN