Idaho Dept Of Health & Welfare Reg 6 Amh Clinic Poc
LBN: Idaho Dept Of Health & Welfare Reg 6 Amh Clinic Poc
Idaho Dept Of Health & Welfare Reg 6 Amh Clinic Poc is an health care organization with primary practice located at 421 Memorial Dr , Pocatello ID 83201-4008. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adult Mental Health, which is considered as the primary health care specialty.
Idaho Dept Of Health & Welfare Reg 6 Amh Clinic Poc can be contacted via phone (208) 234-7900, or through Axford, Ed via phone (208) 234-7900.
Contact Information
Primary practice address
421 Memorial Dr
Pocatello ID 83201-4008
Phone: (208) 234-7900
Fax: (208) 236-6328
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Adult Mental Health | 261QM0850X |
Profile Details
| NPI number | 1811028889 |
|---|---|
| LBN Legal business name | Idaho Dept Of Health & Welfare Reg 6 Amh Clinic Poc |
| DBA Doing business as | |
| Authorized official | Axford, Ed |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 8th, 2007 |
| Last updated | Aug 22nd, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811028889 | NPPES |
| Idaho | Other | 000010019235 | BLUE SHIELD |
| Idaho | Other | HW108 | BLUE SHIELD |
| Idaho | MEDICAID | 0028475 | BLUE SHIELD |
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