Portneuf Medical Center
General Acute Care Hospital, Critical Access in Pocatello, ID. Organization (NPI-2).
NPI number1417210568
StatusActive
Last updated in NPPESJun 22, 2012
Details
- NPI
- 1417210568
- Entity type
- Organization (NPI-2)
- Legal business name
- Portneuf Medical Center
- Organization subpart
- No
- Enumeration date
- Jun 22, 2012
- Last updated
- Jun 22, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 282NC0060X | General Acute Care Hospital, Critical Access | 24374a | ID | Yes |
Practice location
777 Hospital WayPocatello, ID 83201-5175
Phone 208-239-2260
Mailing address
1593 Pointview DrPocatello, ID 83201-2800
Phone 208-241-0651
Authorized official
Norman Stephens
Ceo
2082391004
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