| NPI | 1114731882 |
|---|---|
| Doing Business As | BRIDGE DIALYSIS OF IDAHO |
| Entity Type | Organization |
| Authorized Contact | TANGINA MALOOF Treasurer 469-636-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-04 |