WOLF PACK LLC (NPI# 1992323216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992323216 |
| Entity Type | Organization |
| Organization Name | WOLF PACK LLC |
| Practice Address |
939 S 25th E Ste 115 Ammon ID 83406-5736 |
| Practice Telephone | 2085231209 |
| Mailing Telephone | 2085231209 |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2020-07-13 |
| Authorized Official Name | SHAWN TOLMAN (CEO) |
| Authorized Official Telephone | 2083131089 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Ahhhsome Relaxation | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Wolf Pack LLC | 6371 Stonefly Dr, Colorado Springs, CO 80924-5209 |
| Street Address |
939 S 25TH E STE 115 |
| City | AMMON |
| State | ID |
| Zip Code | 83406-5736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598383929 | Cristina Leon, Do Pa | Pediatrics | Idaho Falls Pediatrics, 3067 Eagle Dr, Ammon, ID 83406 | 2020-07-13 |
| 1144783499 | Mountain States Diabetes Relief, LLC | Internal Medicine | 4573 E Majestic, Idaho Falls, ID 83406 | 2019-04-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
| 1225379183 | Sterling Hospital LLC | General Acute Care Hospital | 5412 S. Rock House Cir, Idaho Falls, ID 83406 | 2013-03-01 |
| 1710236823 | Flower D. Aston | Dietitian, Registered | 300 Bridger Drive, Ammon, ID 83406 | 2012-09-05 |
| 1558658468 | Nathan Myers | Pharmacist | 1901 South 2500 East, Idaho Falls, ID 83406 | 2011-06-30 |
| 1760719934 | Snf Ammon Operating Company LLC. | Skilled Nursing Facility | 3909 South 25th East, Ammon, ID 83406 | 2009-11-10 |
| 1316192370 | A Childs Smile | Dentist | 3299 E. 17th Street, Ammon, ID 83406 | 2008-11-18 |
| 1992968804 | Brandon D Gordon | Dentist | 7186 Sage View Cr, Idaho Falls, ID 83406 | 2008-07-10 |
| 1891996526 | Help, Inc. | Community/Behavioral Health | 1465 Hoopes Ave, Idaho Falls, ID 83406 | 2007-05-30 |
| Find all providers in zip 83406 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790027332 | Jd Optometrics, LLC | Clinic/Center | 1201 S 25th E, Ammon, ID 83406-5729 | 2013-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831730118 | Falls Medical Aesthetics, Pllc | Clinic/Center | 814 Pancheri Dr, Idaho Falls, ID 83402-3344 | 2019-10-08 |
| 1164072187 | Peter John Leichtnam | Clinic/Center | 1200 W Ironwood Dr Ste 309, Coeur D Alene, ID 83814-2660 | 2019-09-12 |
| 1124674437 | Michael J. Moorhouse Inc. | Clinic/Center | 13900 W Wainwright Dr Ste 100, Boise, ID 83713-5028 | 2019-08-13 |
| 1093368276 | Korena Popp Fnp Medical Services LLC | Clinic/Center | 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615-8361 | 2019-07-17 |
| 1528623915 | D & S Works | Clinic/Center | 5622 W State St, Boise, ID 83703-3010 | 2019-05-01 |
| 1609335090 | Hurst Medical Pllc | Clinic/Center | 1700 Overland Ave Ste 1, Burley, ID 83318 | 2019-03-15 |
| 1912487646 | Ideal Option, Pllc | Clinic/Center | 509 W Hanley Ave Ste 101, Coeur D Alene, ID 83815-8994 | 2018-08-21 |
| 1801376256 | Ideal Option, Pllc | Clinic/Center | 1111 Blue Lakes Blvd N Ste E, Twin Falls, ID 83301-3437 | 2018-08-15 |
| 1649759374 | North Canyon Mountain Home Clinic | Clinic/Center | 840 N 4th E, Mountain Home, ID 83647-2166 | 2018-08-13 |
| 1104316785 | Pend Oreille Vision Care | Clinic/Center | 6132 Highway 2, Priest River, ID 83856 | 2018-05-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.