NPI 1952571234

Premier Life Wellness LLC

Organisation Health Maintenance Organization Twin Falls, ID

Practice location

Address: 1625 Addison Ave E, Twin Falls, ID 83301-5343
Phone: (208) 735-2442
Fax: (208) 735-9030

Authorised official

Name: Loraine M Gumper
Title: Owner
Phone: (208) 735-2442

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence CHIA-754 (ID)

Other Health Maintenance Organization providers in Idaho →

Registry record

NPI: 1952571234
Entity type: Organization
NPI issued: 3 Mar 2008
Record last updated: 3 Mar 2008

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.