Provider Demographics
NPI:1083487706
Name:HEALTH WEST, INC.
Entity Type:Organization
Organization Name:HEALTH WEST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-232-7862
Mailing Address - Street 1:500 S 11TH AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-4880
Mailing Address - Country:US
Mailing Address - Phone:120-823-2786
Mailing Address - Fax:
Practice Address - Street 1:75 YELLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-5235
Practice Address - Country:US
Practice Address - Phone:208-232-7862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH WEST, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental