Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Idaho Street Medical Clinic

Organization Health Service Clinic/Center · NPI 1023639622

Idaho Street Medical Clinic is a Health Service Clinic/Center in Homedale, Idaho. Registered with an NPI since 2020.

In the registry since
2020
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Practice location Address checks out

126 W Idaho Ave
Homedale, ID 83628-8362
Phone: (208) 337-7038
Fax: (208) 337-4652
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X

Record details

NPI number1023639622
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edith Roe — Nurse Practitioner · (208) 859-4103
NPI enumeratedMay 5, 2020
Last updated in NPPESMay 5, 2020
Certification dateMay 5, 2020
Mailing address24900 Market Rd, Parma, ID 83660-6723