Phs MD #1, LLC

NPI #1124355813 in Pocatello, Idaho

Provider Information

NPI Number: 1124355813
Entity Type: Organization
Organization Name: Phs MD #1, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: POCATELLO HEALTH SERVICES, LLC
Primary Specialty: Clinic/Center - Primary Care
Enumeration Date: Nov 17, 2009
Last Updated: Mar 2, 2010

Practice Location

Address: 651 MEMORIAL DR
City: Pocatello
State: Idaho
ZIP Code: 83201-4071
Phone: (208) 239-2110

Authorized Official

Name: JOHN ABREU
Title: CFO
Phone: (208) 239-2110

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Primary Care — Primary Care	261QP2300X	Primary

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