CC POCATELLO LLC NPI 1538517156

NPI Information

CC POCATELLO LLC is a family medicine in Pocatello, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CC POCATELLO LLC NPI is 1538517156. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Community Care Pocatello.

The provider's business location address is:

1595 YELLOWSTONE AVE
POCATELLO, ID
ZIP 83201-203
Phone: (208) 233-0032

The provider's authorized official is Joshua Tolman .
The authorized official title is Cao and has the following contact phone number (208) 557-2700.

The CLIA number assigned to this NPI record is 13D1085881 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/25/2016 and was last updated on 5/25/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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