Healthcare Provider Details

I. General information

NPI: 1740287911
Provider Name (Legal Business Name): EASTERN IDAHO HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2005
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2280 E 25TH ST
IDAHO FALLS ID
83404-7542
US

IV. Provider business mailing address

3100 CHANNING WAY
IDAHO FALLS ID
83404-7533
US

V. Phone/Fax

Practice location:
  • Phone: 208-227-2100
  • Fax: 208-227-2368
Mailing address:
  • Phone: 208-529-6111
  • Fax: 208-529-7021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUG CRABTREE
Title or Position: CEO
Credential:
Phone: 208-529-6210