Pocatello Hospital LLC
Organization Active NPI Internal Medicine Physician · Pocatello, ID
NPI 1760610935 · NPPES record last updated Apr 19, 2022
Key facts
- NPI
- 1760610935
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- POCATELLO HOSPITAL LLC
- Practice address
- 651 Memorial Dr
Pocatello, ID 83201-4071 - Phone
- (208) 239-2110
- Fax
- (208) 239-2145
- NPI assigned
- Jun 26, 2009
- Organization subpart
- No
Authorized official
- Name
- Stephen C. Petrovich
- Title
- Evp, General Counsel
- Phone
- (615) 296-3594
Member of 1
Practitioners 177
-
Mara Additon, M.D.
-
Bruce J Andersen, MD
-
Gabriela Anghel, MD
-
Jordan Lyle Bailey, M.D.
-
Harriet Barratt, M.D.
-
Gustin Ross Blad, FNP-BC
-
Avery Marie Burnett, N.P.
-
Robert Lee Cach, M.D.
-
Cade Call, DO
-
Patrick Joseph Cindrich, M.D.
-
Elizabeth Christine Combs, DNP FNP
-
Darryl Bruce Cook, M.D.
-
Jason Lee Cottrell, P.A.
-
Jonathan Cree, MD
-
McKenzie Jo Decker, DNP
-
Jacob Delarosa, MD
-
Krista Michelle Diekemper, RD, LD
-
Skyler Micol Dorius, FNP
-
Katherine N Dorsett, M.D.
-
Brooke Elzey, PA-C
National Provider Directory
Locations
1501 Hiland Ave
Ste B1
Burley, ID 83318
Phone (208) 678-2106
777 Hospital Way
#202
Pocatello, ID 83201
777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640
4240 Yellowstone Ave
Pocatello, ID 83202
Phone (208) 237-5091
500 S 11th Ave
Ste 500
Pocatello, ID 83201
Phone (208) 239-1940
777 Hospital Way
Ste G11
Pocatello, ID 83201
Phone (208) 239-1710
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes | ||
| General Acute Care Hospital | 282N00000X | 12 | ID | |
| Certified Registered Nurse Anesthetist |
367500000X |
Addresses
Primary practice location
651 Memorial Dr
Pocatello, ID 83201-4071
Mailing address
651 Memorial Dr
Pocatello, ID 83201-4071
Phone (208) 239-2110
Other providers in Pocatello, ID
- Pocatello Health Services, LLC
- Pocatello Health Services, LLC
- Pocatello Health Services, LLC
- Pocatello Hospital LLC
- Pocatello Hospital LLC
- Pocatello Hospital LLC
- Pocatello Hospital, LLC
- Pocatello Id Caregiving LLC
- Pocatello Inpatient Services PLLC
- Pocatello Limousine LLP
All providers in Pocatello, ID · Internal Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2022. 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.