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Pocatello Hospital LLC — NPI 1790751055, Pocatello, ID | NPI Central

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NPI 1790751055

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Pocatello Hospital LLC

NPI 1790751055 · General Acute Care Hospital · Pocatello, ID

Provider details

NPI number: 1790751055
Entity type: Organization
Primary specialty: General Acute Care HospitalHospitals
Organization subpart: No
Authorized official: Stephen Petrovich, Evp, General Counsel(615) 296-3594
License: 12 (ID)

Specialties & taxonomies

General Acute Care HospitalPrimary282N00000XLicense 12 (ID)
Hospitals

Practice location

777 Hospital Way

Pocatello, ID 83201-5175

Phone: (208) 239-1000

Fax: (208) 239-1934

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

777 Hospital Way

Pocatello, ID 83201-5175

Other names (DBA / former)

Doing business as: Portneuf Medical Center
Doing business as: Portneuf Medical Center

Registry dates

Enumerated: 2006-02-27
Last updated: 2022-04-19
Certified: 2022-04-19

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.