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Contact Information

DIVISION OF VETERANS SERVICES
1957 ALVIN RICKEN DR
POCATELLO, ID83201-2727
 Phone: 208-236-6340
 Fax: 208-236-6343
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for DIVISION OF VETERANS SERVICES

NPI Number 1285624064
LBN Legal business name DIVISION OF VETERANS SERVICES
Authorized official TRACY SCHANER - (DEPUTY CHIEF ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/24/2005
Last updated 02/24/2026 - About 3 months ago
Identifiers
ID License # 92
ID Medicaid 805755300
ID Medicaid 805788400
ID Other 1307126 NCPDP
ID Other 92 NURSING FACILITY LICENSE
ID Other 995HP PHARMACY LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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