Provider Demographics
NPI:1821735945
Name:URGENT CARE OF IDAHO, LLC
Entity Type:Organization
Organization Name:URGENT CARE OF IDAHO, LLC
Other - Org Name:URGENT CARE OF IDAHO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-324-2004
Mailing Address - Street 1:PO BOX 5809
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83303-5809
Mailing Address - Country:US
Mailing Address - Phone:208-933-4442
Mailing Address - Fax:208-933-4273
Practice Address - Street 1:1309 BLUE LAKES BLVD N
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3310
Practice Address - Country:US
Practice Address - Phone:208-933-4442
Practice Address - Fax:208-933-4273
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URGENT CARE OF IDAHO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-19
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine