PHS AMBULATORY SERVICES LLC – NPI #1306524152
Clinic/Center

PHS AMBULATORY SERVICES LLC is an AHC clinic located in POCATELLO, ID. NPPES has assigned the NPI number 1306524152 to PHS AMBULATORY SERVICES LLC on July 10, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QU0200X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Urgent Care

The NPI profile was previously updated about 3 years ago on Oct 03, 2023. 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 PHS AMBULATORY SERVICES LLC below.

NPI Profile for
PHS AMBULATORY SERVICES LLC

NPI Number
1306524152
Enumeration Date

(about 3 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
PHS AMBULATORY SERVICES LLC
Primary location
2850 OLYMPUS DR
POCATELLO, ID 83201-2271
Phone: (208) 239-2273 Fax:
Mailing address
340 SEVEN SPRINGS WAY STE 100
BRENTWOOD, TN 37027-5697
Phone: Fax:
Organization Subpart
Yes - PHS AMBULATORY SERVICES LLC is subpart of another organization.
Authorized Official
STEPHEN PETROVICH
EVP GENERAL COUNSEL
Phone: (615) 296-3594
Updated
Certification Date
Oct 03, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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
261QU0200X
- Clinic/Center / Urgent Care (Primary)

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.