Organization
SAINT ALPHONSUS REGIONAL MEDICAL CENTER
Active
Other names
SAMG Occ Med Roster Billing
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN LANNIE CHECKETTS (CFO)
(208) 367-2844
Entity
Organization
Contact information
Practice address
6533 W EMERALD ST, BOISE, ID 83704-8737
(208) 302-7600
(208) 302-7605
Mailing address
6533 W EMERALD ST, BOISE, ID 83704-8737
(208) 302-7600
(208) 302-7605
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
M-5535
ID
2083X0100X
Occupational Medicine Physician
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Other
Enumeration date
07/15/2016
Last updated
10/17/2024
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