# SOUTHEASTERN DISTRICT HEALTH DEPT.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396919916
- **Authorized official:** MS. TRICIA NANNETTE CODDING (FACHS DIRECTOR)
- **Authorized official phone:** (208) 233-9080

## Contact information

- **Practice address:** 1901 ALVIN RICKEN DR, POCATELLO, ID 83201-2727
- **Practice address phone:** (208) 233-9080
- **Practice address fax:** (208) 234-7169
- **Mailing address:** 1901 ALVIN RICKEN DR, POCATELLO, ID 83201-2727
- **Mailing address phone:** (208) 233-9080
- **Mailing address fax:** (208) 234-7169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/15/2008
- **Last updated:** 10/28/2008