MEDICARE: EASTERN IDAHO HEALTH SERVICES 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	273R00000X	Psychiatric Hospital Unit

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740287911
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTERN IDAHO HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	3100 CHANNING WAY
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-7533
Country	:	US
Telephone Number	:	208-529-6111
Fax Number	:	208-529-7021

Provider Business Practice Location Address
First Line	:	2280 E 25TH ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-7542
Country	:	US
Telephone Number	:	208-227-2100
Fax Number	:	208-227-2368

Authorized Official
Title or Position	:	CEO
Name	:	MR. DOUG CRABTREE
Credential	:
Telephone Number	:	208-529-6210

Provider Enumeration Date	:	07/04/2005
Last Update Date	:	11/11/2025

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Directions to “EASTERN IDAHO HEALTH SERVICES INC ” Practice Location

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