Organization
POCATELLO HEALTH SERVICES, LLC
Active
Other names
POCATELLO CARDIOLOGY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ABREU (CFO)
(208) 239-1000
Entity
Organization
Contact information
Practice address
777 HOSPITAL WAY BLDG A, STE. 101, POCATELLO, ID 83201-2753
(208) 234-2001
(208) 232-2195
Mailing address
PO BOX 4168, POCATELLO, ID 83205-4168
(208) 234-2001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002507000
—
ID
Enumeration date
08/03/2006
Last updated
11/07/2011
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