MEDICARE: HEALTH WEST, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1013623941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH WEST, INC.

Provider Business Mailing Address
First Line	:	500 S 11TH AVE STE 400
Second Line	:
City	:	POCATELLO
State	:	ID
Zip	:	83201-4880
Country	:	US
Telephone Number	:	208-232-7862
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 W LOGAN RD
Second Line	:
City	:	GARDEN CITY
State	:	UT
Zip	:	84028-7754
Country	:	US
Telephone Number	:	435-946-3660
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL STAFF COORDINATOR
Name	:	AMELIA MURPHY
Credential	:
Telephone Number	:	208-232-7862

Provider Enumeration Date	:	01/24/2023
Last Update Date	:	07/29/2024

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Directions to “HEALTH WEST, INC. ” Practice Location

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