# ST LUKES REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST LUKES INTERNAL MEDICINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316980345
- **Authorized official:** CARRIE LYNNE COWGILL (CREDENTIALING COORDINATOR)
- **Authorized official phone:** (208) 381-4137

## Contact information

- **Practice address:** 520 S EAGLE RD, SUITE 3102, MERIDIAN, ID 83642-6351
- **Practice address phone:** (208) 706-5100
- **Practice address fax:** (208) 706-5169
- **Mailing address:** PO BOX 550, BOISE, ID 83701-0550
- **Mailing address phone:** (208) 706-5100
- **Mailing address fax:** (208) 706-5169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 08/22/2020