Organization
SAINT ALPHONSUS SPECIALTY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ODETTE BOLANO (PRESIDENT)
(208) 367-2118
Entity
Organization
Contact information
Practice address
6140 W CURTISIAN AVE, STE 200, BOISE, ID 83704-0107
(208) 367-4278
Mailing address
1070 N CURTIS RD, STE 250, BOISE, ID 83706-1258
(208) 367-4593
(208) 367-5590
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208M00000X
Hospitalist Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
364S00000X
Clinical Nurse Specialist
—
—
Other
Enumeration date
10/02/2009
Last updated
04/27/2018
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