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General NPI Number Information
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NPI Number | 1104045392
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Entity Type | Organization
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Legal Business Name | SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 3025 W CHERRY LN SUITE D
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City | MERIDIAN
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State | ID
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Zip | 83642
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Country | US
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Telephone | 208-367-8593
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Fax | 208-367-8595
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Provider Business Mailing Address
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Address Line | 901 N CURTIS RD #204
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City | BOISE
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State | ID
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Zip | 83706-1338
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Country | US
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Telephone | 208-367-8950
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Fax | 208-367-6908
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Authorized Official
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Title or Position | CFO & BOARD MEMBER
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Name | BRIAN LANNIE CHECKETTS
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Credential |
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Telephone | 208-367-2844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | ID
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