Organization
STATE OF IDAHO
Active
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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