# EASTERN IDAHO HEALTH SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Eastern Idaho Neurology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114220324
- **Authorized official:** MR. DOUG CRABTREE (CEO)
- **Authorized official phone:** (208) 529-6111

## Contact information

- **Practice address:** 3100 CHANNING WAY, IDAHO FALLS, ID 83404
- **Practice address phone:** (208) 529-6269
- **Mailing address:** 3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
- **Mailing address phone:** (208) 529-6269

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 193400000X | ID | Yes |

## Other

- **Enumeration date:** 12/09/2010
- **Last updated:** 08/27/2018