Provider Demographics
NPI:1043722259
Name:JUST 4 KIDS HEALTH LLC
Entity type:Organization
Organization Name:JUST 4 KIDS HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-656-7396
Mailing Address - Street 1:PO BOX 1407
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83403-1407
Mailing Address - Country:US
Mailing Address - Phone:208-656-7396
Mailing Address - Fax:
Practice Address - Street 1:3320 S 25TH E
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-4606
Practice Address - Country:US
Practice Address - Phone:208-656-1500
Practice Address - Fax:208-656-1502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JUST 4 KIDS HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-27
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty