PORTNEUF MEDICAL CENTER (NPI# 1437191418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437191418 |
| Entity Type | Organization |
| Organization Name | PORTNEUF MEDICAL CENTER |
| Other Organization Name | PORTNEUF PHARMACY |
| Practice Address |
651 Memorial Dr Pocatello ID 83201-4071 |
| Practice Telephone | 2082391000 |
| Practice Fax Number | 2082391970 |
| Mailing Telephone | 2082391000 |
| Mailing Fax Number | 2082391970 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOHNATHAN WILKER (VP FINANCE & CFO) |
| Authorized Official Telephone | 2082391020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | H12 | ID | Pharmacy Service Providers |
| Other Name | Type Code |
|---|---|
| Portneuf Pharmacy | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417210568 | Portneuf Medical Center | General Acute Care Hospital | 777 Hospital Way, Pocatello, ID 83201-5175 | 2012-06-22 |
| 1205005832 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-02-28 |
| 1679742209 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-02-28 |
| 1538351796 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2007-08-13 |
| 1750323515 | Portneuf Medical Center | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
| 1578505335 | Portneuf Medical Center | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
| 1326080599 | Portneuf Medical Center | Skilled Nursing Facility | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
| 1053353227 | Portneuf Medical Center | Home Health | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2006-06-12 |
| Street Address |
651 MEMORIAL DR |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-4071 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871558239 | Michael L Francisco | Internal Medicine | 651 Memorial Dr, Portneuf Cancer Center, Pocatello, ID 83201 | 2006-04-19 |
| 1497051544 | Pocatello Health Services, LLC | Psychologist | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2011-02-08 |
| 1124355813 | Phs Md #1, LLC | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-11-17 |
| 1760719454 | Phs Md #2, LLC | Clinic/Center | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-11-17 |
| 1689802852 | Pocatello Health Services, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-06-26 |
| 1760610935 | Pocatello Hospital, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-06-26 |
| 1295974368 | William E Hogan | Family Medicine | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-02-13 |
| 1083852727 | Pocatello Health Services, LLC | General Acute Care Hospital | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2009-02-03 |
| 1932369568 | Ana Joy Weinhold | Family Medicine | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-17 |
| 1528228806 | Steven D Proctor | Social Worker | 651 Memorial Dr, Pocatello, ID 83201-4071 | 2008-06-11 |
| Find all providers in the same location | ||||
| 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 Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568078046 | Peter Chad Adamovich | Pharmacist | 3553 Summit Dr, Pocatello, ID 83201-8011 | 2020-09-19 |
| 1619523420 | Eric L Thomas | Pharmacist | 319 Roosevelt Ave, Pocatello, ID 83201-5025 | 2019-08-16 |
| 1265996003 | Emilee Risher | Pharmacist | 2442 Shayla Pl, Pocatello, ID 83201-7016 | 2019-01-25 |
| 1659855450 | Cheyanne Jane Williams | Pharmacist | 1465 Bannock Hwy, Pocatello, ID 83204-5077 | 2018-09-18 |
| 1760907869 | Rebecca Hoover | Pharmacist | 921 S 8th Ave Stop 8288, Pocatello, ID 83209-0002 | 2017-08-09 |
| 1457753394 | Allison Ann Cardona | Pharmacist | 26 Columbia St, Pocatello, ID 83201-3458 | 2014-09-23 |
| 1699191478 | Martin Joseph Reed | Pharmacist | 388 Filmore Ave, Pocatello, ID 83201 | 2014-03-17 |
| 1639506033 | Victoria Autumn Gombert Hayes | Pharmacist | 921 S 8th Ave Stop 8333, Isu College of Pharmacy, Pocatello, ID 83209-8333 | 2013-09-30 |
| 1790032431 | Wynnona Sarah Warren | Pharmacist | 911 North Main Street, Pocatello, ID 83204 | 2012-08-13 |
| 1720346018 | Cara Mccoy | Pharmacist | 5901 Country Club Dr, Pocatello, ID 83204-4631 | 2012-04-24 |
| Find all providers in POCATELLO | ||||
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| 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.