Provider Demographics
NPI:1205495371
Name:AAA AMERICAN HEALTHCARE LLC
Entity type:Organization
Organization Name:AAA AMERICAN HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-538-3122
Mailing Address - Street 1:1327 E 17TH ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6235
Mailing Address - Country:US
Mailing Address - Phone:208-538-3122
Mailing Address - Fax:
Practice Address - Street 1:665 JOHN ADAMS PKWY
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4072
Practice Address - Country:US
Practice Address - Phone:208-538-3122
Practice Address - Fax:208-789-2705
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AAA AMERICAN HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty