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Organization
ST. JOSEPH REGIONAL MEDICAL CENTER
Active
Organization
ST. JOSEPH REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBURN (DIRECTOR OF BUSINESS SERVICES)
(208) 799-5200
Entity
Organization
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
(208) 799-5554
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
(208) 799-5554
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
ID
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010033840
REGENCE OF ID DME
ID
05
—
002271500
—
ID
05
—
6009633
—
WA
01
—
8E365
BLUE CROSS OF ID DME
ID
Enumeration date
02/06/2007
Last updated
05/07/2012
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