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Organization

ST LUKE'S REGIONAL MEDICAL CENTER

Active
Parent organization
ST LUKE'S REGIONAL MEDICAL CENTER
Other names
St Luke's Clinic - St Luke's Family Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST LUKE'S REGIONAL MEDICAL CENTER
Authorized official
JEFF TAYLOR (SYSTEM VP CFO)
(208) 381-2520
Entity
Organization

Contact information

Practice address
3090 E GENTRY WAY, STE 200, MERIDIAN, ID 83642-3501
(208) 887-6813
Mailing address
2083 E HOSPITALITY LN, BOISE, ID 83716-6603
(208) 887-6813

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03
ID
363L00000X
Nurse Practitioner
03
ID

Other

Enumeration date
12/21/2010
Last updated
12/21/2010
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