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General NPI Number Information
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NPI Number | 1295542843
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Entity Type | Organization
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Legal Business Name | GENUINE MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 109 N ARTHUR AVE STE 102
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City | POCATELLO
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State | ID
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Zip | 83204-3105
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Country | US
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Telephone | 208-646-3906
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Fax | 208-904-2200
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Provider Business Mailing Address
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Address Line | 4732 MOUNTAIN PARK RD
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City | CHUBBUCK
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State | ID
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Zip | 83202-1703
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Country | US
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Telephone | 208-705-4630
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH C ERICKSON
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Credential | DNP FNP
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Telephone | 208-705-4630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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