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Mangum Primary Care LLC — NPI 1194494229, Boise, ID | NPI Central

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NPI 1194494229

OrganizationActive

Mangum Primary Care LLC

NPI 1194494229 · Primary Care Clinic/Center · Boise, ID

Provider details

NPI number: 1194494229
Entity type: Organization
Primary specialty: Primary Care Clinic/CenterAmbulatory Health Care Facilities
Organization subpart: No
Authorized official: Meredith Mangum, Owner(801) 793-8124

Specialties & taxonomies

Primary Care Clinic/CenterPrimary261QP2300X
Ambulatory Health Care Facilities

Practice location

3046 S Bown Way

Boise, ID 83706-5499

Phone: (801) 793-8124

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

608 S Phillippi St

Boise, ID 83705-1160

Additional practice locations (1)

3050 N Lakeharbor Ln Ste 120
Boise, ID 83703-6917
Phone: (208) 550-3456

Registry dates

Enumerated: 2021-09-11
Last updated: 2021-09-11
Certified: 2021-09-11

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.