PHS MD #2, LLC


Address: 651 Memorial Dr, Pocatello, ID 83201-4071
Phone: 2082392110

PHS MD #2, LLC (NPI# 1760719454) 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) 1760719454
Entity Type Organization
Organization Name PHS MD #2, LLC
Other Organization Name PORTNEUF MEDICAL PRACTICES
Practice Address 651 Memorial Dr
Pocatello
ID 83201-4071
Mailing Address Po Box 4168
Pocatello
ID 83205-4168
Practice Telephone 2082392110
Practice Fax Number 2082392145
Mailing Telephone 2082392110
Mailing Fax Number 2082392145
Enumeration Date 2009-11-17
Last Update Date 2010-03-02
Authorized Official Name JOHN ABREU (CFO)
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 261QM1300X Clinic/Center
Specialization: Multi-Specialty
ID Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
PORTNEUF MEDICAL PRACTICES Other Name - Individual/Organization

Office Location

Street Address 651 MEMORIAL DR
City POCATELLO
State ID
Zip Code 83201-4071

Providers in the same location

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
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
1871753061 Elisabeth Gayle Kinghorn Clinical Nurse Specialist 651 Memorial Dr, Pocatello, ID 83201-4071 2008-06-11
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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
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073747929 Ihc Health Services Inc Clinic/Center 777 Hospital Way, Pocatello, ID 83201-2753 2009-05-06
1538238571 Idaho Orthopedic & Sports Clinic Pa Clinic/Center 560 Memorial Dr, Pocatello, ID 83201-4073 2006-11-06

Providers in the same taxonomy and state

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1609327022 Finding Home Healthcare, Inc. Clinic/Center 55 W Willowbrook Dr Ste 103, Meridian, ID 83646 2016-10-20
1346799483 Healing Sanctuary LLC Clinic/Center 187 E 13th St, Idaho Falls, ID 83404-5305 2016-09-30
1760741334 Saint Alphonsus Regional Medical Center Inc Clinic/Center 131 Constitution Way, Nampa, ID 83686 2012-05-16
1750681607 Family Services, Pllc Clinic/Center 501 N 16th St Ste 108, Payette, ID 83661-2782 2010-10-26
1043545106 Ashwood Recovery LLC. Clinic/Center 7941 W Rifleman St, Boise, ID 83704-9001 2009-10-07
1922037530 St Benedicts Family Medical Center Clinic/Center 115 5th Ave W, Jerome, ID 83338-1824 2006-07-03
1659371870 Saint Alphonsus Medical Center Nampa, Inc. Clinic/Center 4300 E Flamingo Ave, Nampa, ID 83687-3138 2005-07-29
1881200517 Vannvei LLC Clinic/Center 1522 17th St, Lewiston, ID 83501-3652 2020-09-18
1831716182 Regenesis Health Centre Inc. Clinic/Center 430 W Iowa Ave Ste A, Nampa, ID 83686-2826 2020-07-02
1568005809 Pure Healthcare of Idaho LLC Clinic/Center 6560 W Emerald St Ste 122, Boise, ID 83704-8781 2019-10-18
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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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