OrganizationActive
Idaho Street Medical Clinic
NPI 1063970143 · Rural Health Clinic/Center · Homedale, ID
Provider details
- NPI number
- 1063970143
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Edith Roe, President
Mailing address
Po Box 37
Homedale, ID 83628-0037
Registry dates
- Enumerated
- 2019-03-07
- Last updated
- 2019-03-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.