Healthcare Provider Details

I. General information

NPI: 1730136490
Provider Name (Legal Business Name): TANABELL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 FLOYDE ST
MCCALL ID
83638-4508
US

IV. Provider business mailing address

1009 W QUINN RD
POCATELLO ID
83202-2425
US

V. Phone/Fax

Practice location:
  • Phone: 208-634-2112
  • Fax: 208-634-3605
Mailing address:
  • Phone: 208-221-0481
  • Fax: 775-307-4049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number16
License Number StateID

VIII. Authorized Official

Name: MR. TROY V BELL
Title or Position: CEO
Credential:
Phone: 208-221-0481