| Pocatello Hospital Llc | |
|
777 Hospital Way Pocatello ID 83201-5175 | |
| (208) 239-1000 | |
| (208) 239-2134 |
| Full Name | Pocatello Hospital Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 777 Hospital Way, Pocatello, Idaho |
| Authorized Official Name and Position | Stephen C. Petrovich (EVP GENERAL COUNSEL) |
| Authorized Official Contact | 6152963594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pocatello Hospital Llc 777 Hospital Way Pocatello ID 83201-5175 Ph: (208) 239-1000 | Pocatello Hospital Llc 777 Hospital Way Pocatello ID 83201-5175 Ph: (208) 239-1000 |
| NPI Number | 1295777274 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 04/19/2022 |
| Certification Date | 04/19/2022 |
| Medicare PECOS PAC ID | 8527115534 |
|---|---|
| Medicare Enrollment ID | O20091216000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295777274 | NPI | - | NPPES |
| 806570500 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | H12 (Idaho) | Primary |
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Antler And Moss Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 756 Ash St, Pocatello, ID 83201 Phone: 208-252-5087 | |
Whole Health Haven Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 N Arthur Ave Ste 203, Pocatello, ID 83204 Phone: 208-406-4724 | |
Apex Professional Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Wilson Ave, Suite C-3, Pocatello, ID 83201 Phone: 208-904-0225 Fax: 866-704-4580 | |
Behavioral Reform Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1135 Yellowstone Ave Ste D, Pocatello, ID 83201 Phone: 208-238-9400 Fax: 208-238-9401 | |
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