Provider Demographics
NPI:1447376355
Name:PLANNED PARENTHOOD OF IDAHO
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF IDAHO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:208-376-9300
Mailing Address - Street 1:3668 NORTH HARBOR LANE
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703
Mailing Address - Country:US
Mailing Address - Phone:208-376-9300
Mailing Address - Fax:208-376-9444
Practice Address - Street 1:3668 N HARBOR LANE
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83703
Practice Address - Country:US
Practice Address - Phone:208-376-9300
Practice Address - Fax:208-376-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center