NPIMap

Organization Active NPI

Pocatello Hospital, LLC

  • Non-Pharmacy Dispensing Site
  • Pocatello, ID
National Provider Identifier
1700659935
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
POCATELLO HOSPITAL, LLC
Practice address
777 Hospital Way
Pocatello, ID 83201-5175
Phone
(208) 239-1000
NPI assigned
Oct 31, 2023
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
POCATELLO HEALTH SYSTEM, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen C. Petrovich
Title
Evp, General Counsel
Phone
(615) 296-3594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

777 Hospital Way
Pocatello, ID 83201-5175

Mailing address

340 Seven Springs Way Ste 100
Brentwood, TN 37027-5697
Phone (615) 296-3000

National Provider Directory

National Provider Directory
Tax ID family
Pocatello Hospital LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1700659935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 SEVEN SPRINGS WAY STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275697",
            "telephone_number": "615-296-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POCATELLO HOSPITAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POCATELLO HEALTH SYSTEM, LLC",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EVP, GENERAL COUNSEL",
        "authorized_official_telephone_number": "615-296-3594"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.