PHS MD #1, LLC


Address: 465 Memorial Dr, Pocatello, ID 83201-4008
Phone: 2082392110

PHS MD #1, LLC (NPI# 1992032098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992032098
Entity Type Organization
Organization Name PHS MD #1, LLC
Other Organization Name POCATELLO FAMILY MEDICINE
Practice Address 465 Memorial Dr
Pocatello
ID 83201-4008
Mailing Address Po Box 4728
Pocatello
ID 83205-4728
Practice Telephone 2082392110
Practice Fax Number 2082392145
Mailing Telephone 2082392110
Mailing Fax Number 2082392145
Enumeration Date 2009-11-10
Last Update Date 2010-03-02
Authorized Official Name JOHN ABREU (ADMINISTRATIVE DIRECTOR)
Authorized Official Telephone 2082392110
Is Organization Subpart Y
Parent Organization Name POCATELLO HEALTH SERVICES, LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
POCATELLO FAMILY MEDICINE Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1124355813 Phs Md #1, LLC Clinic/Center 651 Memorial Dr, Pocatello, ID 83201-4071 2009-11-17

Office Location

Street Address 465 MEMORIAL DR
City POCATELLO
State ID
Zip Code 83201-4008

Providers in the same location

NPI Name Taxonomy Address Enumeration
1578555603 Nicole Murdock Pharmacist 465 Memorial Dr, Pocatello, ID 83201-4008 2005-08-16
1538785191 Kailey Jo Murphy Pharmacist 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-19
1568087435 Sye Speth Family Medicine 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-16
1376168013 Martin Steele Family Medicine 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-09
1356965396 Jokke Kokkonen Family Medicine 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-05
1649894692 Richard John Family Medicine 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-05
1972127942 Tyshae Jaggi Family Medicine 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-04
1003430174 Emily Davis Family Medicine 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-03
1134743628 Brandon Dean Comish Family Medicine 465 Memorial Dr, Pocatello, ID 83201-4008 2020-06-01
1598318792 Brandon Griffin Dentist 465 Memorial Dr, Pocatello, ID 83201-4008 2019-07-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235765330 Timothy Palmer Social Worker 400 S 11th Ave, Ste 204, Pocatello, ID 83201 2020-03-20
1225687759 Hanna Percy Nurse Practitioner 1151 Hospital Way Ste 201, Pocatello, ID 83201 2019-09-07
1659935195 Carol Jane Dillon Counselor 707 North 7th Avenue, Suite D, Pocatello, ID 83201 2019-04-30
1154801595 Mv Pocatello Ent, LLC Otolaryngology 333 N 18th Ave Ste B3, Pocatello, ID 83201 2018-08-15
1306344346 Ruth Anne Patton Social Worker 850 E Young St, Pocatello, ID 83201 2018-01-24
1598289274 Lucas Alexander Bryan Specialist/Technologist 1535 E Terry St, Pocatello, ID 83201 2017-08-03
1205365632 Geno Alan Giovanini Denturist 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 2017-06-08
1518415942 Kelli Fries-geslin Nurse Practitioner 500 South 11 Ave Suite 400, Pocatello, ID 83201 2016-09-14
1346797842 Shailyn Jenkins Specialist/Technologist 665 Warren Ave., Pocatello, ID 83201 2016-09-01
1992258149 Christopher Jared White Social Worker 300 N 7th Ave, Pocatello, ID 83201 2016-07-24
Find all providers in zip 83201

Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1700379682 Vera Whole Health, Wa PC Clinic/Center 219 Phil Meador Ave, Pocatello, ID 83202 2018-06-14
1760739973 Pocatello Family Medicine Clinic/Center 465 Memorial Drive, Pocatello, ID 83201-4008 2012-08-07
1508875881 Primary Care Specialists, Pa Clinic/Center 110 Vista Drive, Pocatello, ID 83201 2006-08-05
1003231911 Need-a-nurse Medical Staffing, LLC Clinic/Center 476 E Chubbuck Rd, Pocatello, ID 83202-1816 2014-02-28
1275894065 Alice D. Bollinger Clinic/Center 444 Hospital Way, Pocatello, ID 83201-2745 2012-06-07
1700147543 Becky Lee Morrison Clinic/Center 444 Hospital Way, Pocatello, ID 83201-2745 2012-06-07
1245591080 Colleen E. Hallinan Clinic/Center 444 Hospital Way, Suite 801, Pocatello, ID 83201-2745 2012-06-07
1548521396 Nanette Marie Phinney Clinic/Center 444 Hospital Way, Suite 801, Pocatello, ID 83201-2745 2012-06-07
1285936781 Bmh Inc. Clinic/Center 2302 E Terry St, Pocatello, ID 83201-2733 2010-12-03
1124355813 Phs Md #1, LLC Clinic/Center 651 Memorial Dr, Pocatello, ID 83201-4071 2009-11-17
Find all providers in POCATELLO

Competitor

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City POCATELLO
Zip Code 83201

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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