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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

NPI # 1508875360
LBN Legal business name DIAGNOSTIC IMAGING SERVICE OF IDAHO
Authorized official JAMES EVERSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/07/2006
Last updated 06/18/2012 - About 14 years ago
Identifiers
ID Medicaid 804301300
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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