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PORTNEUF MEDICAL CENTER NPI 1578505335


NPI Information

NPI: 1578505335
Provider Name: PORTNEUF MEDICAL CENTER

Other Name: POCATELLO (ISU) FAMILY MEDICINE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
651 MEMORIAL DR
POCATELLO, ID
ZIP 83201
Phone: (208) 282-4700
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PORTNEUF MEDICAL CENTER is a clinic center in Pocatello, ID. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PORTNEUF MEDICAL CENTER NPI is 1578505335. The provider is registered as an organization entity type.
The provider Other Name Is Pocatello (isu) Family Medicine.

The provider's business location address is:

651 MEMORIAL DR
POCATELLO, ID
ZIP 83201-071
Phone: (208) 282-4700
Fax: (208) 282-4969

The provider's authorized official is Johnathan Wilker .
The authorized official title is Vp Finance & Cfo and has the following contact phone number (208) 239-1020.

The enumeration date for this NPI number is 6/12/2006 and was last updated on 8/22/2020.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterH12IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.