Southeastern District Health Department

LBN: State Of Idaho
Southeastern District Health Department is an health care organization with primary practice located at 1901 Alvin Ricken Dr , Pocatello ID 83201-2727. The organization recently has only one registered license in Agencies / Public Health or Welfare, which is considered as the primary health care specialty. State Of Idaho can be contacted via phone (208) 239-5242, or through Marugg, Edward A. via phone (208) 233-9080.

Contact Information

Primary practice address
1901 Alvin Ricken Dr Pocatello ID 83201-2727
Phone: (208) 239-5242
Fax: (208) 478-9297
Website:
Map and Directions
Authorized official contact:
Name: Marugg, Edward A. R.E.H.S
Phone: (208) 233-9080

Health care specialties

SpecialtyCodeLicense #State
Agencies / Public Health or Welfare 251K00000X

Profile Details

NPI number 1811028319
LBN Legal business name State Of Idaho
DBA Doing business as Southeastern District Health Department
Authorized official Marugg, Edward A. R.E.H.S
Entity Organization
Organization subpart 1 No
Enumeration date Mar 8th, 2007
Last updated Jul 10th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811028319 NPPES
Idaho MEDICAID 002834600

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