| Health West Pocatello Clinic | |
|
1000 N 8th Ave Pocatello ID 83201-5757 | |
| (208) 232-6260 | |
| (208) 232-6259 |
| Full Name | Health West Pocatello Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1000 N 8th Ave, 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 Pocatello Clinic Po Box 2377 Pocatello ID 83206-2377 Ph: (208) 232-7862 | Health West Pocatello Clinic 1000 N 8th Ave Pocatello ID 83201-5757 Ph: (208) 232-6260 |
| NPI Number | 1154320752 |
|---|---|
| Provider Enumeration Date | 07/18/2005 |
| Last Update Date | 08/17/2020 |
| Medicare PECOS PAC ID | 4981500931 |
|---|---|
| Medicare Enrollment ID | O20051219000786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154320752 | NPI | - | NPPES |
| 8C519 | Other | ID | BCI CLINIC NUMBER |
| 805670100 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M7806 (Idaho) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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