Organization
PORTNEUF MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY WRIGHT (CREDENTIALING SPECIALIST)
(208) 239-2110
Entity
Organization
Contact information
Practice address
651 MEMORIAL DR, POCATELLO, ID 83201-4071
(208) 239-2110
Mailing address
651 MEMORIAL DR, POCATELLO, ID 83201-4071
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
RPA166
ID
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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