MEDICARE: SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1760741334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT ALPHONSUS REGIONAL MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 190930
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83719-0930
Country	:	US
Telephone Number	:	208-302-9342
Fax Number	:	208-367-5180

Provider Business Practice Location Address
First Line	:	131 CONSTITUTION WAY
Second Line	:
City	:	NAMPA
State	:	ID
Zip	:	83686
Country	:	US
Telephone Number	:	208-367-3315
Fax Number	:	208-367-6908

Authorized Official
Title or Position	:	CFO
Name	:	BRIAN LANNIE CHECKETTS
Credential	:
Telephone Number	:	208-367-7347

Provider Enumeration Date	:	05/16/2012
Last Update Date	:	03/16/2026

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