Advanced Healthcare Solutions LLC
Organization Active NPI Non-Pharmacy Dispensing Site · Pocatello, ID
NPI 1144504663 · NPPES record last updated Oct 3, 2011
Key facts
- NPI
- 1144504663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Non-Pharmacy Dispensing Site 332900000X
- Legal business name
- ADVANCED HEALTHCARE SOLUTIONS LLC
- Practice address
- 950 Hospital Way
Pocatello, ID 83201-2789 - Phone
- (208) 232-0021
- NPI assigned
- Oct 3, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- ADVANCED HEALLHCARE SOLUTIONS LLC
Authorized official
- Name
- Randy Vawdrey, NP
- Title
- Coo
- Phone
- (208) 232-0021
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Advanced Healthcare
- Part of
- Advanced Healthcare
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Pharmacy Dispensing Site | 332900000X | Yes |
Addresses
Primary practice location
950 Hospital Way
Pocatello, ID 83201-2789
Mailing address
2980 N Beverly Glen Cir Ste 301
Los Angeles, CA 90077-1735
Phone (310) 474-9809
Other names
- Physicians Immediate Care Center
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All providers in Pocatello, ID · Non-Pharmacy Dispensing Site in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.