Provider Demographics
NPI:1588334874
Name:APPLMD, LLC
Entity type:Organization
Organization Name:APPLMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:COLETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-541-5590
Mailing Address - Street 1:875 N CAPITAL AVE UNIT 51511
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83405-7058
Mailing Address - Country:US
Mailing Address - Phone:888-827-7563
Mailing Address - Fax:
Practice Address - Street 1:256 S HEATH LN APT 1
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4644
Practice Address - Country:US
Practice Address - Phone:208-541-5590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center