PHS MD #2 LLC NPI 1760719454

NPI Information

  • NPI: 1760719454
  • Provider Name: PHS MD #2, LLC
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Other Name: PORTNEUF MEDICAL PRACTICES
  • Address: 651 MEMORIAL DR
    POCATELLO, ID
    ZIP 83201
  • Phone: (208) 239-2110

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NPI Details

PHS MD #2, LLC is a multi-specialty clinic center in Pocatello, ID. PHS MD #2, LLC NPI is 1760719454. The provider is registered as an organization entity type.
The provider Other Name Is Portneuf Medical Practices.

The provider's business location address is:

651 MEMORIAL DR
POCATELLO, ID
ZIP 83201-071
Phone: (208) 239-2110
Fax: (208) 239-2145

The provider's authorized official is John Abreu .
The authorized official title is Cfo and has the following contact phone number (208) 239-2110.

The enumeration date for this NPI number is 11/17/2009 and was last updated on 3/2/2010.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyIDAHOYes

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: 3/30/2025

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