NPI 1295597821

Evernorth Care Providers - Arizona PC

Organisation General Practice Physician Boise, ID

Practice location

Address: 950 W Bannock St STE 1100, Boise, ID 83702-6140
Phone: (773) 292-4800
Fax: (312) 564-4059
Mailing address: 730 Cool Springs Blvd STE 500, Franklin, TN 37067-7331

Authorised official

Name: Grace Blue
Title: Credentialing Sr. Manager
Phone: (773) 292-4800

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Idaho →

Registry record

NPI: 1295597821
Entity type: Organization
NPI issued: 29 Jan 2024
Record last updated: 29 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.