Organization · Type 2 NPI
Portneuf Nephrology Center
End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Pocatello, ID
NPI number
1164413753
Active
Practice location
2001 Bench Rd
Pocatello, ID 83201-2033
Fax (208) 637-1097
Mailing address
5610 Gage St
Boise, ID 83706-1332
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary | 261QE0700X | BM7847203 (ID) |
End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...
2 other providers at this address
Other end-stage renal disease (esrd) treatment clinic/center providers in Pocatello
About NPI 1164413753
Portneuf Nephrology Center's National Provider Identifier is 1164413753, issued on Nov 2, 2005. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Pocatello, ID. The record was last updated on Aug 22, 2020.