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General NPI Number Information
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NPI Number | 1568852119
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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 | 02/03/2015
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 6533 W EMERALD ST
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City | BOISE
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State | ID
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Zip | 83704
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Country | US
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Telephone | 208-367-6206
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Fax | 208-367-6811
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Provider Business Mailing Address
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Address Line | 3340 E GOLDSTONE WAY
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City | MERIDIAN
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State | ID
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Zip | 83642-1026
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Country | US
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Telephone | 208-367-6206
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Fax | 208-367-6811
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Authorized Official
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Title or Position | CFO
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Name | BRIAN LANNIE CHECKETTS
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Credential |
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Telephone | 208-367-7347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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