Provider Demographics
NPI:1619344637
Name:TMHCARE, PC
Entity type:Organization
Organization Name:TMHCARE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCELREE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-446-5127
Mailing Address - Street 1:250 NORTHWEST BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2973
Mailing Address - Country:US
Mailing Address - Phone:208-215-1568
Mailing Address - Fax:
Practice Address - Street 1:250 NORTHWEST BLVD STE 200
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2973
Practice Address - Country:US
Practice Address - Phone:208-215-1568
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP3300X
VA01012588122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Single Specialty