State Of Idaho is a Home Health in Pocatello, Idaho. State Of Idaho practices all healthcare services and medical treatments related to Home Health. The NPI Number for State Of Idaho is 1649277393. The last update date is 2020-08-22.
State Of Idaho's current location address is 1901 Alvin Ricken Dr, Pocatello, Idaho. You can contact this provider via phone number 2082395210 and fax number 2084786306. The mailing address for State Of Idaho is 1901 Alvin Ricken Dr, Pocatello, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | State Of Idaho |
|---|---|
| Address | 1901 Alvin Ricken Dr, Pocatello, Idaho |
| Phone Number | 2082395210 |
| Fax Number | 2084786306 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR |
|---|---|
| Authorized Official Name | Marugg A. Edward |
| Credentials | R.E.H.S |
| Telephone Number | 2082339080 |
NPI Number Detail
| NPI Number | 1649277393 |
|---|---|
| Provider Enumeration Date | 2005-07-07 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1901 Alvin Ricken Dr |
|---|---|
| City | Pocatello |
| State | Idaho (ID) |
| Post Code | 832012727 |
| Phone Number | 2082395210 |
| Fax Number | 2084786306 |
Provider's Primary Taxonomy Detail
| Speciality | Home Health |
|---|---|
| Taxonomy | 251E00000X |
| Licence No | 13-7001 |
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Definition: A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, |
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What is the unique identification code assigned to State Of Idaho by the Centers for Medicare & Medicaid Services?
The State Of Idaho has been issued the NPI (National Provider Identifier) 1649277393. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of State Of Idaho?
The State Of Idaho is physically situated at 1901 Alvin Ricken Dr, in the city of Pocatello, state of ID, with the postal code 832012727.
What is the State Of Idaho's specialty and taxonomy code?
The State Of Idaho's specialty is Home Health, and the corresponding taxonomy code is 251E00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1649277393 to State Of Idaho?
The State Of Idaho received its 1649277393 assignment from the Centers for Medicare & Medicaid Services on 2005-07-07.
When was the State Of Idaho's information last updated?
The State Of Idaho's information was last updated on 2020-08-22.