institution
State Of Idaho
Public Health or Welfare Agency in Pocatello, Idaho
NPI 1063576445

State Of Idaho is a Public Health or Welfare Agency based in Pocatello, ID. State Of Idaho practices in Pocatello, ID. The NPI Number for State Of Idaho is 1063576445 and holds a License No. (Idaho).

The current practice location address for State Of Idaho is 1901 Alvin Ricken Dr, Pocatello, ID and can be reached out via phone at 208-233-9080 and via fax at 208-478-9297.

Location: 1901 Alvin Ricken Dr, Pocatello, ID, 83201-2727
institution
Provider Profile Details
NPI Number
1063576445
Provider Name
State Of Idaho
Credential
Provider Entity Type
Organization
Address
1901 Alvin Ricken Dr, Pocatello, ID, 83201-2727
Phone Number
208-233-9080
Fax Number
208-478-9297
Provider Enumeration Date
12/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
002834600 05 ID
002832700 05 ID
002470300 05 ID
institution
Provider Business Practice Location Address Details
Address
1901 Alvin Ricken Dr
City
State
Zip
83201-2727
Phone Number
208-233-9080
Fax Number
208-478-9297
person
Provider Business Mailing Address Details
Address
1901 Alvin Ricken Dr
City
State
Zip
83201-2727
Phone Number
208-233-9080
Fax Number
208-478-9297
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Public Health or Welfare
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
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