# IDAHO STATE UNIVERSITY HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IDAHO STATE UNIVERSITY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1336214618
- **Legal business name:** IDAHO STATE UNIVERSITY
- **Authorized official:** DR. RONALD M SOLBRIG MD (DIRECTOR)
- **Authorized official phone:** (208) 282-2330

## Contact information

- **Practice address:** 990 CESAR CHAVEZ AVE, POCATELLO, ID 83209-0001
- **Practice address phone:** (208) 282-2330
- **Practice address fax:** (208) 282-4036
- **Mailing address:** 921 S 8TH AVE STOP 8311, POCATELLO, ID 83209-0002
- **Mailing address phone:** (208) 282-2330
- **Mailing address fax:** (208) 282-4036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1000X | Student Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/21/2006
- **Last updated:** 02/26/2015