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General NPI Number Information
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NPI Number | 1629173588
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Entity Type | Organization
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Legal Business Name | SAINT ALPHONSUS MEDICAL CENTER- ONTARIO INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 824 SW 4TH AVENUE
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City | ONTARIO
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State | OR
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Zip | 97914-2639
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Country | US
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Telephone | 541-881-7430
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Fax | 541-881-7181
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Provider Business Mailing Address
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Address Line | 351 SW 9TH STREET
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City | ONTARIO
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State | OR
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Zip | 97914-2639
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Country | US
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Telephone | 541-881-7000
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Fax | 541-881-7184
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 13140026
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HH-136
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 13-1398
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License Number State | OR
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