Healthcare Provider Details

I. General information

NPI: 1225375991
Provider Name (Legal Business Name): SAINT ALPHONSUS MEDICAL CENTER -BAKER CITY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 POCAHONTAS RD
BAKER CITY OR
97814-1464
US

IV. Provider business mailing address

3325 POCAHONTAS RD
BAKER CITY OR
97814-1464
US

V. Phone/Fax

Practice location:
  • Phone: 541-524-2965
  • Fax: 541-523-8151
Mailing address:
  • Phone: 541-524-2965
  • Fax: 541-523-8151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN LANNIE CHECKETTS
Title or Position: CFO
Credential:
Phone: 208-367-7347