OrganizationActive
State of Idaho
NPI 1902995814 · Community Based Hospice Care Agency · Pocatello, ID
State of Idaho is a Community Based Hospice Care Agency organization in Pocatello, ID (NPI 1902995814).
Provider details
- NPI number
- 1902995814
- Entity type
- Organization
- Primary specialty
- Community Based Hospice Care AgencyAgencies
- Organization subpart
- No
- Authorized official
- Edward Marugg, District Director(208) 233-9080
- License
- 13-1512 (ID)
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(90/100 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) 239-5240
Fax: (208) 478-6306
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
- 2006-10-11
- Last updated
- 2020-08-22
Frequently asked questions
- What is State of Idaho's NPI number?
- State of Idaho's National Provider Identifier (NPI) is 1902995814, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is State of Idaho?
- State of Idaho is classified in the NPPES registry as Community Based Hospice Care Agency (Agencies).
- Where is State of Idaho located?
- State of Idaho's practice location on file with NPPES is 1901 Alvin Ricken Dr, Pocatello, ID 83201-2727.
- What is State of Idaho's phone number?
- The practice phone number listed in the NPPES registry for State of Idaho is (208) 239-5240.
- Who is the authorized official for State of Idaho?
- The authorized official listed on State of Idaho's NPPES record is Edward Marugg, District Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is State of Idaho's NPI active?
- Yes — State of Idaho's NPI (1902995814) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.