SOUTHERN IDAHO DIABETES EDUCATION PROGRAM

SHOSHONE, ID
NPI1154572311
Entity TypeOrganization
Authorized ContactKATHRYN EVALENA PIKE
Sidep COO Rdinator
208-944-4747
Organization Subpart ?Yes
Primary Taxonomy261QP2300X Clinic/Center Primary Care
Enumeration Date2008-10-07
Last Update Date2008-10-07
Business Address
SOUTHERN IDAHO DIABETES EDUCATION PROGRAM
108 NW RAIL ST
SHOSHONE, ID 83352
Phone number: 208-944-4747
Mailing Address
SOUTHERN IDAHO DIABETES EDUCATION PROGRAM
113 S APPLE ST
SHOSHONE, ID 83352-5287
Phone number: 208-886-6222
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