NPI 1902995814 · live from the CMS NPI Registry
State Of Idaho
Hospice Care, Community Based in Pocatello, ID. National Provider Identifier 1902995814, active.
NPI record
| NPI | 1902995814 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Hospice Care, Community Based 251G00000X |
| Practice location | 1901 Alvin Ricken Dr, Pocatello, ID 83201 |
| Practice phone | 208-239-5240 |
| Enumerated | October 11, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Edward Marugg, District Director |
| Other names | Southeastern District Health Department |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Care, Community Based primary | 251G00000X | 13-1512 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.