# SAINT ALPHONSUS PHYSICIAN SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Saint Alphonsus Medical Group Emerald
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992738736
- **Authorized official:** MS. JANELLE G. REILLY (PRESIDENT)
- **Authorized official phone:** (208) 367-6490

## Contact information

- **Practice address:** 6533 W EMERALD ST, BOISE, ID 83704-8737
- **Practice address phone:** (208) 367-4170
- **Practice address fax:** (208) 367-8135
- **Mailing address:** 3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
- **Mailing address phone:** (208) 367-5170
- **Mailing address fax:** (208) 367-5180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/07/2006
- **Last updated:** 12/21/2007