OrganizationActive
Phs MD #1, LLC
NPI 1124355813 · Primary Care Clinic/Center · Pocatello, ID
Provider details
- NPI number
- 1124355813
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Pocatello Health Services, LLC
- Authorized official
- John Abreu, Cfo
Practice location
651 Memorial Dr
Pocatello, ID 83201-4071
Phone: (208) 239-2110
Fax: (208) 239-2145
Mailing address
Po Box 4168
Pocatello, ID 83205-4168
Registry dates
- Enumerated
- 2009-11-17
- Last updated
- 2010-03-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.