NPI age
19 years
Enumerated 2007-05-14
● Active Type 2 · Organization
South Park, Inc.
South Park, Inc. is 1 of 55 nursing care organizations in Idaho.
Primary specialty
Nursing Care
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
McCoy
Executive Director
Last NPPES update
2020-08-22
Source: monthly bulk 2026-05
How this organization compares
Across 55 active nursing care providers in Idaho.
NPI age
19 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-05Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
415 S Arthur Ave
Pocatello, ID 832043303
Mailing address
415 S Arthur Ave
Pocatello, ID 832043303
Authorized official
Russell C McCoy, M.A.ED
Executive Director
📞 2082336833
Specialties
-
Nursing Care PrimaryA Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Developmental Options
Practice context
Single-site organization. Only one practice location on file.
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