Organization · Type 2 NPI
Idaho State University
Health Service Clinic/Center · Chubbuck, ID
NPI number
1457060790
Active
Practice location
4914 Yellowstone Ave Ste B
Chubbuck, ID 83202-2332
Mailing address
990 S 8th Ave Stop 8158
Pocatello, ID 83201-4982
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | None listed |
| Health Service Clinic/Center Primary | 261QH0100X | None listed |
Health Service Clinic/Center: Definition to come...
Other health service clinic/center providers in Chubbuck
About NPI 1457060790
Idaho State University's National Provider Identifier is 1457060790, issued on Nov 15, 2022. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Chubbuck, ID. The record was last updated on Jul 13, 2026.