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Contact Information

DIAGNOSTIC IMAGING SERVICE OF IDAHO
1951 BENCH RD
SUITE F
POCATELLO, ID83201-2073
 Phone: 208-237-0977
 Fax: 208-237-0985
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiography Radiologic Technologist

2471C3402X
 

Radiology, Mobile

261QR0208X 45 Mammography Center
Indicates primary specialty

NPI Profile & details for DIAGNOSTIC IMAGING SERVICE OF IDAHO · (Female)

NPI Number 1508875360
Status Active
Credentials
Entity Individual
Enumeration date 08/07/2006
Last updated 06/18/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID Medicaid 804301300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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