Provider Demographics
NPI:1932464989
Name:NORTH IDAHO LUNG, ASTHMA AND CRITICAL CARE, LLC.
Entity Type:Organization
Organization Name:NORTH IDAHO LUNG, ASTHMA AND CRITICAL CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-765-1252
Mailing Address - Street 1:700 W IRONWOOD DR
Mailing Address - Street 2:SUITE 336
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2656
Mailing Address - Country:US
Mailing Address - Phone:208-765-1252
Mailing Address - Fax:208-765-1494
Practice Address - Street 1:700 W IRONWOOD DR
Practice Address - Street 2:SUITE 336
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2656
Practice Address - Country:US
Practice Address - Phone:208-765-1252
Practice Address - Fax:208-765-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty