Organization
PORTNEUF MEDICAL CENTER
Active
Other names
Portneuf Medical Practices
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHAN WILKER (VP FINANCE & CFO)
(208) 239-1020
Entity
Organization
Contact information
Practice address
651 MEMORIAL DR, POCATELLO, ID 83201-4071
(208) 239-1000
(208) 239-3741
Mailing address
PO BOX 4168, POCATELLO, ID 83205-4168
(208) 239-1000
(208) 239-3741
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H12
ID
Other
Enumeration date
06/12/2006
Last updated
06/03/2008
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