Provider Demographics
NPI:1649965336
Name:MEDICAL SOLUTIONS HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:MEDICAL SOLUTIONS HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:ODOM
Authorized Official - Suffix:
Authorized Official - Credentials:RNP-C
Authorized Official - Phone:801-574-5277
Mailing Address - Street 1:1550 N CRESMONT DR
Mailing Address - Street 2:SUITE G
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642
Mailing Address - Country:US
Mailing Address - Phone:208-629-2023
Mailing Address - Fax:208-759-5840
Practice Address - Street 1:1550 N CRESTMONT DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-2184
Practice Address - Country:US
Practice Address - Phone:801-574-5277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-07
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty