Provider Demographics
NPI:1639481286
Name:NOMSIRI GROUP INC
Entity type:Organization
Organization Name:NOMSIRI GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISARA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOMSIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-319-3587
Mailing Address - Street 1:950 W BANNOCK ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5999
Mailing Address - Country:US
Mailing Address - Phone:208-319-3587
Mailing Address - Fax:
Practice Address - Street 1:950 W BANNOCK ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5999
Practice Address - Country:US
Practice Address - Phone:208-319-3587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty