OrganizationActive
State of Idaho
NPI 1821129420 · Public Health or Welfare Agency · Pocatello, ID
Provider details
- NPI number
- 1821129420
- Entity type
- Organization
- Primary specialty
- Public Health or Welfare AgencyAgencies
- Organization subpart
- No
- Authorized official
- Edward Marugg, Director(208) 233-9080
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1901 Alvin Ricken Dr
Pocatello, ID 83201-2727
Phone: (208) 239-5242
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
- 2007-03-08
- Last updated
- 2008-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.