Organization
STATE OF IDAHO
Active
Other names
Southeastern District Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD A. MARUGG R.E.H.S. (DISTRICT DIRECTOR)
(208) 233-9080
Entity
Organization
Contact information
Practice address
1901 ALVIN RICKEN DR, POCATELLO, ID 83201-2727
(208) 239-5240
(208) 478-6306
Mailing address
1901 ALVIN RICKEN DR, POCATELLO, ID 83201-2727
(208) 239-5240
(208) 478-6306
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
13-1512
ID
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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