TETON OPEN MRI OF POCATELLO LLC NPI 1194798397

NPI Information

NPI: 1194798397
Provider Name: TETON OPEN MRI OF POCATELLO, LLC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
246 N 18TH AVE
POCATELLO, ID
ZIP 83201
Phone: (208) 552-0828
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TETON OPEN MRI OF POCATELLO, LLC is a radiology clinic center in Pocatello, ID. TETON OPEN MRI OF POCATELLO, LLC NPI is 1194798397. The provider is registered as an organization entity type.

The provider's business location address is:

246 N 18TH AVE
POCATELLO, ID
ZIP 83201-356
Phone: (208) 552-0828
Fax: (208) 552-0829

The provider's authorized official is Bonnie C Gray .
The authorized official title is Administrative Assistant and has the following contact phone number (208) 552-0828.

The enumeration date for this NPI number is 2/8/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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