Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

State of Idaho

Organization Community Based Hospice Care Agency · NPI 1902995814

State of Idaho is a Community Based Hospice Care Agency in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006

Practice location Address checks out

1901 Alvin Ricken Dr
Pocatello, ID 83201-2727
Phone: (208) 239-5240
Fax: (208) 478-6306
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community Based Hospice Care Agency (primary) Taxonomy 251G00000X · Licence 13-1512 (ID)

Record details

NPI number1902995814
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edward Marugg — District Director · (208) 233-9080
Other names Southeastern District Health Department
NPI enumeratedOctober 11, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1901 Alvin Ricken Dr, Pocatello, ID 83201-2727

Other providers in Pocatello