Provider Demographics
NPI:1912221318
Name:UNITY HEALTH CENTER PLLC
Entity Type:Organization
Organization Name:UNITY HEALTH CENTER PLLC
Other - Org Name:UNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:SWAINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:208-895-6729
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83680-0314
Mailing Address - Country:US
Mailing Address - Phone:208-895-6729
Mailing Address - Fax:208-855-5921
Practice Address - Street 1:1130 E FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-1813
Practice Address - Country:US
Practice Address - Phone:208-895-6729
Practice Address - Fax:208-855-5921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty