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Organization

POCATELLO HOSPITAL LLC

Active
Parent organization
PORTNEUF MEDICAL CENTER
Other names
Portneuf Rehabilitation Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
PORTNEUF MEDICAL CENTER
Authorized official
STEPHEN C. PETROVICH (EVP, GENERAL COUNSEL)
(615) 296-3594
Entity
Organization

Contact information

Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-1000
(208) 239-1934
Mailing address
777 HOSPITAL WAY, POCATELLO, ID 83201-5175
(208) 239-1000
(208) 239-1934

Taxonomy

Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
H12
ID

Other

Enumeration date
06/12/2006
Last updated
04/19/2022
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