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Organization

ST LUKES IDAHO CARDIOLOGY ASSOCIATES

Active
Parent organization
GRANDE RONDE HOSPITAL, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
GRANDE RONDE HOSPITAL, INC
Authorized official
MR. JAMES A MATTES (PRESIDENT/CEO)
(541) 963-1454
Entity
Organization

Contact information

Practice address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 322-1680
Mailing address
900 SUNSET DR, PO BOX 3290, LA GRANDE, OR 97850-1362
(541) 963-1555
(541) 963-1845

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
140728
OR

Other

Enumeration date
04/20/2011
Last updated
04/20/2011
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