# ST LUKES FAMILY HEALTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649220385
- **Authorized official:** CAROL JOHNSON (ASSISTANT ADMINISTRATOR)
- **Authorized official phone:** (208) 887-4606

## Contact information

- **Practice address:** 3090 E GENTRY WAY, SUITE 200, MERIDIAN, ID 83642-3501
- **Practice address phone:** (208) 887-4606
- **Practice address fax:** (208) 887-0810
- **Mailing address:** 3090 E GENTRY WAY, SUITE 200, MERIDIAN, ID 83642-3501
- **Mailing address phone:** (208) 887-4606
- **Mailing address fax:** (208) 887-0810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2006
- **Last updated:** 04/14/2008