Pocatello Children'S Clinic

LBN: Pocatello Children'S Clinic
Pocatello Children'S Clinic is an health care organization with primary practice located at 500 S 11Th Ave Ste 204, Pocatello ID 83201-4835. The organization recently has only one registered license in Suppliers / Durable Medical Equipment & Medical Supplies, which is considered as the primary health care specialty. Pocatello Children'S Clinic can be contacted via phone (208) 232-1443, or through Perry, Jessica via phone (208) 236-9600.

Contact Information

Primary practice address
500 S 11Th Ave Ste 204 Pocatello ID 83201-4835
Phone: (208) 232-1443
Fax: (208) 239-3434
Website:
Map and Directions
Authorized official contact:
Name: Perry, Jessica
Phone: (208) 236-9600

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X Idaho

Profile Details

NPI number 1023287828
LBN Legal business name Pocatello Children'S Clinic
DBA Doing business as
Authorized official Perry, Jessica
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2008
Last updated Feb 26th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023287828 NPPES
Idaho MEDICAID 807621700

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