MEDICARE: SAINT ALPHONSUS CALDWELL CANCER TREATMENT CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471R0002X	Radiation Therapy Radiologic Technologist

General Provider Information

NPI Number	:	1053522961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT ALPHONSUS CALDWELL CANCER TREATMENT CENTER LLC

Provider Business Mailing Address
First Line	:	3123 MEDICAL DR STE A
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-6972
Country	:	US
Telephone Number	:	208-455-2033
Fax Number	:	208-367-4817

Provider Business Practice Location Address
First Line	:	3123 MEDICAL DR STE A
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-6972
Country	:	US
Telephone Number	:	208-455-2033
Fax Number	:	208-367-4817

Authorized Official
Title or Position	:	MANAGER
Name	:	SHELLY ANN GORMAN
Credential	:
Telephone Number	:	208-205-0066

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	03/16/2026

Similar Medicare Providers

1386614519 — IDAHO SURGERY CENTER, LLC
Practice Location Address:

3115 MEDICAL DRIVE
CALDWELL, ID
83605-6972

Practice Phone: 208-453-8668
Practice Fax: 208-453-8448

1497899512 — SAINT ALPHONSUS CALDWELL CANCER TREATMENT CENTER LLC
Practice Location Address:

3123 MEDICAL DR STE A
CALDWELL, ID
83605-6972

Practice Phone: 208-367-4808
Practice Fax: 208-367-4817

1871918318 — WEST IDAHO ANESTHESIA, LLP
Practice Location Address:

3115 MEDICAL DR
CALDWELL, ID
83605-6972

Practice Phone: 208-453-8668
Practice Fax: 208-523-2025

1750797486 — LEILA KHADDOUR MD
Practice Location Address:

3123 MEDICAL DR
CALDWELL, ID
83605-6972

Practice Phone: 208-367-3131
Practice Fax: 208-367-4817

1437625662 — ISABELLA M SATTERTHWAIT PA-C
Practice Location Address:

3123 MEDICAL DR
CALDWELL, ID
83605-6972

Practice Phone: 208-367-3131
Practice Fax: 208-367-4817

1629930722 — IAN KENNETH ANDERSON PHARMD
Practice Location Address:

3123 MEDICAL DR
CALDWELL, ID
83605-6972

Practice Phone: 208-367-3131
Practice Fax:

Directions to “SAINT ALPHONSUS CALDWELL CANCER TREATMENT CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.