Saint Alphonsus Physician Services INC
Clinic/Center, Primary Care in Meridian, ID. Organization (NPI-2).
NPI number1821032376
StatusActive
Last updated in NPPESDec 27, 2007
Details
- NPI
- 1821032376
- Entity type
- Organization (NPI-2)
- Legal business name
- Saint Alphonsus Physician Services INC
- Organization subpart
- No
- Enumeration date
- Jun 15, 2006
- Last updated
- Dec 27, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Other names
- Saint Alphonsus Medical Group Ten Mile (Doing Business As)
Practice location
3250 W Cherry LnMeridian, ID 83642-1120
Phone 208-895-8969
Mailing address
3340 E Goldstone WayMeridian, ID 83642-1026
Phone 208-367-5170 · Fax 208-367-5180
Authorized official
Janelle G. Reilly
President
2083676490
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