SOUTHEASTERN IDAHO PUBLIC HEALTH
NPI 1750526216
Public Health or Welfare in Pocatello, ID

Q: What is Southeastern District Health Department's specialty?

The primary specialty registered for this NPI is Public Health or Welfare with taxonomy code 251K00000X.

Active since December 11, 2008CLIA 13D0662579 · Microscopy

1901 ALVIN RICKEN DR, POCATELLO, ID 83201(208) 233-9080(208) 478-9297 Get Directions Write a Review

NPPES record last updated: August 4, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Southeastern Idaho Public Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHEASTERN IDAHO PUBLIC HEALTH (NPI 1750526216) is a healthcare organization registered as a public health or welfare in Pocatello, Idaho and active in the NPI registry since December 2008. The organization holds a CLIA Microscopy certificate valid through September 5, 2026 and lists Maggie Mann, District Director, as its authorized official.

NPPES Registry Identity

NPI1750526216

Entity TypeOrganization

Primary Taxonomy251K00000X

Legal Business NameSOUTHEASTERN DISTRICT HEALTH DEPARTMENT

Location Address1901 ALVIN RICKEN DRPocatello, ID 83201-2727

Mailing Address1901 Alvin Ricken DrPocatello, ID 83201-2727 · (208) 233-9080 · Fax (208) 478-9297

Phone(208) 233-9080

Fax(208) 478-9297

Organization SubpartNo

Authorized OfficialMaggie MannDistrict Director · (208) 239-5258

Enumeration DateDecember 11, 2008

Last NPPES UpdateAugust 4, 2015

✔ NPI 1750526216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPublic Health or WelfareAgencies

Taxonomy Code251K00000X

1901 ALVIN RICKEN DR, Pocatello, ID 83201

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Other Names 1

Doing Business AsSoutheastern Idaho Public Health

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 13D0662579

Southeastern Idaho Public Health · Pocatello, ID

Active · expires Sep 5, 2026

CLIA Number13D0662579

Laboratory TypePractitioner Other

Certificate Effective DateSeptember 6, 2024

Certificate Expiration DateSeptember 5, 2026

Laboratory DirectorLuis M. Fernandez

Laboratory Phone(208) 239-5218

Laboratory LocationSoutheastern Idaho Public Health1901 Alvin Ricken Dr, Pocatello, ID 83201

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

956 services945 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

913 services903 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

136 services136 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

88 services88 patients

Administration of pneumococcal, influenza, hepatitis b, and/or covid-19 vaccine inside a patient's home; reported only once per individual home per date of service when such vaccine administration(s) are performed at the patient's home M0201

The Covid-19 vaccine can be administered at your home for convenience and safety. This service is reported once per home, per date, when only the vaccine is given. It's a straightforward process where a medical professional visits your home to give the vaccine.

17 services17 patients

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHEASTERN DISTRICT HEALTH DEPARTMENT

Public Health or Welfare