Pocatello Hospital LLC

NPI #1760610935 in Pocatello, Idaho

Provider Information

NPI Number
1760610935
Entity Type
Organization
Organization Name
Pocatello Hospital LLC
Primary Specialty
Internal Medicine
Enumeration Date
Jun 26, 2009
Last Updated
Apr 19, 2022

Practice Location

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

Authorized Official

Name
STEPHEN C. PETROVICH
Title
EVP, GENERAL COUNSEL
Phone
(615) 296-3594

Specialties & Taxonomy Codes

Specialty
General Acute Care Hospital
Nurse Anesthetist, Certified Registered
Internal Medicine

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