Healthcare Provider Details

I. General information

NPI: 1386636355
Provider Name (Legal Business Name): SAINT ALPHONSUS MEDICAL CENTER BAKER CITY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
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: 541-523-6461
  • Fax: 541-523-8151
Mailing address:
  • Phone: 541-523-6461
  • Fax: 541-523-8151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State

VIII. Authorized Official

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