Portneuf Medical Center
General Acute Care Hospital in Pocatello, ID. Organization (NPI-2).
NPI number1679742209
StatusActive
Last updated in NPPESFeb 28, 2008
Details
- NPI
- 1679742209
- Entity type
- Organization (NPI-2)
- Legal business name
- Portneuf Medical Center
- Organization subpart
- No
- Enumeration date
- Feb 28, 2008
- Last updated
- Feb 28, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 282N00000X | General Acute Care Hospital | 12 | ID | Yes |
Practice location
651 Memorial DrPocatello, ID 83201-4071
Phone 208-239-2110
Mailing address
651 Memorial DrPocatello, ID 83201-4071
Authorized official
Kerry Wright
Enrollment Specialist
2082392110
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