Healthcare Provider Details

I. General information

NPI: 1306872858
Provider Name (Legal Business Name): SAINT ALPHONSUS PHYSICIAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N CURTIS RD SUITE 407
BOISE ID
83706-1336
US

IV. Provider business mailing address

999 N CURTIS RD SUITE 407
BOISE ID
83706-1336
US

V. Phone/Fax

Practice location:
  • Phone: 208-367-4321
  • Fax: 208-367-4525
Mailing address:
  • Phone: 208-367-4321
  • Fax: 208-367-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number StateID

VIII. Authorized Official

Name: MR. STEPHEN FRANEY
Title or Position: CEO
Credential:
Phone: 208-367-7270