| Greenacres Elementary School | |
|
1250 E Oak St Pocatello ID 83201-3940 | |
| (208) 232-7862 | |
| Not Available |
| Full Name | Greenacres Elementary School |
|---|---|
| Speciality | Clinic/Center |
| Location | 1250 E Oak St, 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 |
|---|---|
| Greenacres Elementary School 500 S 11th Ave Ste 400 Pocatello ID 83201-4880 Ph: (208) 232-7862 | Greenacres Elementary School 1250 E Oak St Pocatello ID 83201-3940 Ph: (208) 232-7862 |
| NPI Number | 1134895071 |
|---|---|
| Provider Enumeration Date | 08/20/2021 |
| Last Update Date | 03/26/2026 |
| Certification Date | 03/26/2026 |
| Medicare PECOS PAC ID | 4981500931 |
|---|---|
| Medicare Enrollment ID | O20220804002853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134895071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
| 101YS0200X | Counselor - School | () | Secondary |
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