Organization · Type 2 NPI

State of Idaho

Public Health or Welfare Agency · Pocatello, ID

NPI number 1811028319 Active

Practice location

1901 Alvin Ricken Dr
Pocatello, ID 83201-2727

Call (208) 239-5242 Map

Fax (208) 478-9297

Specialties and licenses

TaxonomyCodeLicense
Public Health or Welfare Agency Primary 251K00000XNone listed

Public Health or Welfare Agency: Definition to come...

12 other providers at this address

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About NPI 1811028319

State of Idaho's National Provider Identifier is 1811028319, issued on Mar 8, 2007. The primary taxonomy on file is Public Health or Welfare Agency (251K00000X), and the practice location is in Pocatello, ID. The record was last updated on Jul 10, 2008.