Healthcare Provider Details

I. General information

NPI: 1144673021
Provider Name (Legal Business Name): SAINT ALPHONSUS REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6533 W EMERALD ST
BOISE ID
83704-8737
US

IV. Provider business mailing address

6533 W EMERALD ST
BOISE ID
83704-8737
US

V. Phone/Fax

Practice location:
  • Phone: 208-302-7600
  • Fax: 208-302-7605
Mailing address:
  • Phone: 208-302-7600
  • Fax: 208-302-7605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberM-5535
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARCIE HARPER
Title or Position: CFO
Credential:
Phone: 208-367-7192