Provider Demographics
NPI:1124618079
Name:TAMARACK WELLNESS LLC
Entity type:Organization
Organization Name:TAMARACK WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEINOST
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:208-245-6997
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:SANTA
Mailing Address - State:ID
Mailing Address - Zip Code:83866-0061
Mailing Address - Country:US
Mailing Address - Phone:208-582-1737
Mailing Address - Fax:
Practice Address - Street 1:31 E DAVIS
Practice Address - Street 2:
Practice Address - City:SANTA
Practice Address - State:ID
Practice Address - Zip Code:83866
Practice Address - Country:US
Practice Address - Phone:208-245-6997
Practice Address - Fax:833-673-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health