Pocatello Health Services, LLC
General Acute Care Hospital in Pocatello, ID. Organization (NPI-2).
NPI number1215165485
StatusActive
Last updated in NPPESApr 18, 2012
Details
- NPI
- 1215165485
- Entity type
- Organization (NPI-2)
- Legal business name
- Pocatello Health Services, LLC
- Organization subpart
- No
- Enumeration date
- Jun 26, 2009
- Last updated
- Apr 18, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 282N00000X | General Acute Care Hospital | 12 | ID | Yes |
Other names
- Portneuf Medical Practices (Doing Business As)
Practice location
777 Hospital WayPocatello, ID 83201-5175
Phone 208-239-2065 · Fax 208-239-3754
Mailing address
Po Box 4168Pocatello, ID 83205-4168
Phone 208-239-2065 · Fax 208-239-3754
Authorized official
John E Abreu
Cfo
2082391020
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