1958 (NPI# 1013306307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013306307 |
Entity Type | Organization |
Organization Name | 1958 |
Practice Address |
730 E Clark St #4657 Pocatello ID 83205-5401 |
Mailing Address |
9344 National Blvd Apt 11 Los Angeles CA 90034-2925 |
Practice Telephone | 6198384593 |
Mailing Telephone | 6198384593 |
Enumeration Date | 2015-01-09 |
Last Update Date | 2015-01-09 |
Authorized Official Name | LORAINE POWELL (REGISTERED NURSE) |
Authorized Official Telephone | 6198384593 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
728144 | CA | Hospitals |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | 1958 | 17936 150th St, Danville, IA 52623-9147 |
Colorado Business Entities | 1958 Barbershop, LLC | 1592 Greystone Dr, Carbondale, CO 81623-1832 |
New York State Corporations | 1958 CONSTRUCTION INC | 13235 Sanford Ave 4b, Flushing, Ny 11355 |
New York State Corporations | 1958 CROSS BRONX EXPY LLC | 31 Preston Lane, Syosset, Ny 11791 |
New York State Corporations | 1958 CROSSBRONX EXPRESSWAY CORP. | 1958 Crossbronx Expressway, Bronx, Ny 10472 |
Connecticut Business Registrations | 1958 DINER LLC | 361 Boston Post Rd, North Windham, CT 06256 |
New York State Corporations | 1958 EASTCHESTER ROAD ASSET, LLC | P.o. Box 817, Yonkers, New York 10704 |
New York State Corporations | 1958 EGGERT ROAD, LLC | 709 Cleveland Drive, Cheektowaga, Ny 14225 |
Colorado Business Entities | 1958 LLC | 1250 E. 130th Ave C, Thornton, CO 80241 |
System for Award Management (SAM) Entities | 1958 LLC, A COLORADO LIMITED LIABILITY COMPANY | 1250 E 130th Ave Unit C, Thornton, CO 80241-1152 |
Street Address |
730 E CLARK ST #4657 |
City | POCATELLO |
State | ID |
Zip Code | 83205-5401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417155284 | Stephen M Maloff Md Pa | Plastic Surgery | 1950 E Clark Street, Suite A, Pocatello, ID 83205 | 2007-07-03 |
1528054830 | Super Save Drug | Durable Medical Equipment & Medical Supplies | 701 East Center, Pocatello, ID 83205-4869 | 2005-09-22 |
1912993213 | Super Save Drug, Inc | Pharmacy | 701 East Center St., Pocatello, ID 83205-4869 | 2005-09-22 |
1689945883 | Thomas John Mcdevitt | Otolaryngology | 237 South 7th Ave., Thomas J. Mcdevitt, Pocatello, ID 83205-4928 | 2012-01-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265033484 | Ala, LLC | Case Management | 818 E Lander St, Pocatello, ID 83201-5763 | 2020-11-04 |
1639779523 | Tracie Lyn Hansen | Peer Specialist | 560 Fairway Dr, Pocatello, ID 83201-2012 | 2020-10-29 |
1104424191 | Jo Anna Shotiveyaratana | Counselor | 707 W Wyeth St, Pocatello, ID 83204-3058 | 2020-10-13 |
1811595929 | Idaho State University | Counselor | 1400 E Terry Dr Bldg 63, Pocatello, ID 83209-0001 | 2020-10-12 |
1871190215 | Cardiovascular Specialists of America, LLC | Internal Medicine | 1515 E Clark St, Pocatello, ID 83201-4133 | 2020-10-08 |
1568078046 | Peter Chad Adamovich | Pharmacist | 3553 Summit Dr, Pocatello, ID 83201-8011 | 2020-09-19 |
1639784648 | Alyssa Mabey | Occupational Therapy Assistant | 659 Fairway Dr, Pocatello, ID 83201-2049 | 2020-09-15 |
1023622321 | Jessica Michelle Wilson-lucero | Psychologist | 395 1/2 Willard Ave, Pocatello, ID 83201-4524 | 2020-09-03 |
1316551187 | Atropos Mental Health | Case Management | 217 S 9th Ave, Pocatello, ID 83201-5351 | 2020-08-31 |
1265045199 | Julia Claire Brodie | Physician Assistant | 2352 N Apple Ln, Pocatello, ID 83204-7231 | 2020-08-29 |
Find all providers in POCATELLO |
Taxonomy Code | 282NR1301X |
Grouping | Hospitals |
Classification | General Acute Care Hospital |
Specialization | Rural |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558582429 | Bonner General Hospital, Inc | General Acute Care Hospital | 520 N 3rd Ave, Sandpoint, ID 83864-1507 | 2007-05-01 |
Please comment or provide details below to improve the information on 1958.
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.