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Organization
ST LUKES REGIONAL MEDICAL CENTER
Active
Organization
ST LUKES REGIONAL MEDICAL CENTER
Active
Other names
ST LUKES INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE LYNNE COWGILL (CREDENTIALING COORDINATOR)
(208) 381-4137
Entity
Organization
Contact information
Practice address
4840 N CLOVERDALE RD, BOISE, ID 83713-2423
(208) 706-8000
(208) 706-8001
Mailing address
PO BOX 550, BOISE, ID 83701-0550
(208) 706-8000
(208) 706-8001
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/07/2006
Last updated
10/31/2007
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