Healthcare Provider Details

I. General information

NPI: 1760524904
Provider Name (Legal Business Name): SALTZER MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E HAWAII AVE
NAMPA ID
83686-6011
US

IV. Provider business mailing address

217 W GEORGIA AVE STE 115
NAMPA ID
83686-6812
US

V. Phone/Fax

Practice location:
  • Phone: 208-463-3234
  • Fax: 208-463-3044
Mailing address:
  • Phone: 208-463-3234
  • Fax: 208-463-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA A MALLOY
Title or Position: ADMINISTRATIVE ASSISTANT
Credential:
Phone: 208-463-3103