Organization
PHS MD #2, LLC
Active
Organization
PHS MD #2, LLC
Active
Parent organization
POCATELLO HEALTH SERVICES, LLC
Other names
PORTNEUF MEDICAL PRACTICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
POCATELLO HEALTH SERVICES, LLC
Authorized official
JOHN ABREU (CFO)
(208) 239-2110
Entity
Organization
Contact information
Practice address
651 MEMORIAL DR, POCATELLO, ID 83201-4071
(208) 239-2110
(208) 239-2145
Mailing address
PO BOX 4168, POCATELLO, ID 83205-4168
(208) 239-2110
(208) 239-2145
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
ID
Other
Enumeration date
11/17/2009
Last updated
03/02/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up