Healthcare Provider Details

I. General information

NPI: 1649692609
Provider Name (Legal Business Name): TANABELL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W 1ST N
REXBURG ID
83440
US

IV. Provider business mailing address

4881 CLOVER DELL RD
POCATELLO ID
83202-1805
US

V. Phone/Fax

Practice location:
  • Phone: 208-359-7676
  • Fax: 208-359-7677
Mailing address:
  • Phone: 208-252-5902
  • Fax: 775-307-4049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number135140
License Number StateID

VIII. Authorized Official

Name: TROY V BELL
Title or Position: CEO PRESIDENT
Credential: MBA, NHA
Phone: 208-221-0481