NPI 1063576445

State of Idaho

Organisation Public Health or Welfare Agency Pocatello, ID

Practice location

Address: 1901 Alvin Ricken Dr, Pocatello, ID 83201-2727
Phone: (208) 233-9080
Fax: (208) 478-9297

Authorised official

Name: Edward A. Marugg
Title: Director
Phone: (208) 233-9080

Registered specialties

Public Health or Welfare Agency Primary

Agencies Taxonomy 251K00000X

Other Public Health or Welfare providers in Idaho →

Registry record

NPI: 1063576445
Entity type: Organization
NPI issued: 20 Dec 2006
Record last updated: 30 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.