PORTNEUF NEPHROLOGY CENTER – NPI #1164413753
Clinic/Center

PORTNEUF NEPHROLOGY CENTER is an AHC clinic located in POCATELLO, ID. NPPES has assigned the NPI number 1164413753 to PORTNEUF NEPHROLOGY CENTER on November 02, 2005. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PORTNEUF NEPHROLOGY CENTER below.

NPI Profile for
PORTNEUF NEPHROLOGY CENTER

NPI Number
1164413753
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PORTNEUF NEPHROLOGY CENTER
Primary location
2001 BENCH RD
POCATELLO, ID 83201-2033
Phone: (208) 637-1090 Fax: (208) 637-1097
Mailing address
5610 GAGE ST
BOISE, ID 83706-1332
Phone: (208) 367-3076 Fax: (208) 367-6909
Organization Subpart
No
Authorized Official
JAN JACOBS
ACCOUNTS RECEIVABLE MANAGER
Phone: (208) 367-3076
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)
ID BM7847203

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.