OrganizationActive
State of Idaho
NPI 1063576445 · Public Health or Welfare Agency · Pocatello, ID
Provider details
- NPI number
- 1063576445
- Entity type
- Organization
- Primary specialty
- Public Health or Welfare AgencyAgencies
- Organization subpart
- No
- Authorized official
- Edward Marugg, Director(208) 233-9080
Specialties & taxonomies
Agencies
Practice location
1901 Alvin Ricken Dr
Pocatello, ID 83201-2727
Phone: (208) 233-9080
Fax: (208) 478-9297
Approximate (ZIP-level) locationGet directions
Mailing address
1901 Alvin Ricken Dr
Pocatello, ID 83201-2727
Other names (DBA / former)
- Doing business as
- Southeastern District Health Department
Registry dates
- Enumerated
- 2006-12-20
- Last updated
- 2008-06-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.