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General NPI Number Information
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NPI Number | 1689915365
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 03/06/2013
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 415 6TH ST
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City | LEWISTON
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State | ID
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Zip | 83501-2431
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Country | US
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Telephone | 208-743-2511
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Fax | 208-799-5528
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Provider Business Mailing Address
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Address Line | 415 6TH ST
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City | LEWISTON
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State | ID
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Zip | 83501-2431
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Country | US
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Telephone | 208-799-5528
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Fax | 208-799-5528
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. TOM SAFLEY
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Credential |
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Telephone | 208-799-5696
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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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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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