Provider Demographics
NPI:1265621908
Name:ON SITE FOR SENIORS INC
Entity type:Organization
Organization Name:ON SITE FOR SENIORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RENDERING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MELCHIORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-967-4771
Mailing Address - Street 1:PO BOX 238
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-0238
Mailing Address - Country:US
Mailing Address - Phone:208-967-4771
Mailing Address - Fax:208-683-8101
Practice Address - Street 1:296 W SUNSET AVE STE 14
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8367
Practice Address - Country:US
Practice Address - Phone:208-967-4771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDDG7201OtherMEDICARE RAILROAD CARRIER
ID1370054Medicare PIN