| Health West, Inc. | |
|
1455 Gwen Dr Pocatello ID 83204-4860 | |
| (208) 232-7862 | |
| Not Available |
| Full Name | Health West, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1455 Gwen Dr, Pocatello, Idaho |
| Authorized Official Name and Position | Amelia Murphy (MEDICAL STAFF COORDINATOR) |
| Authorized Official Contact | 2082327862 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health West, Inc. 500 S 11th Ave Ste 400 Pocatello ID 83201-4880 Ph: (208) 232-7862 | Health West, Inc. 1455 Gwen Dr Pocatello ID 83204-4860 Ph: (208) 232-7862 |
| NPI Number | 1699383737 |
|---|---|
| Provider Enumeration Date | 07/15/2020 |
| Last Update Date | 07/15/2020 |
| Certification Date | 07/15/2020 |
| Medicare PECOS PAC ID | 4981500931 |
|---|---|
| Medicare Enrollment ID | O20200916002705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699383737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YS0200X | Counselor - School | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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