Organization
ST LUKE'S HUMPHREYS DIABETES CENTER INC
Active
Other names
Humphreys Diabetes Center INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT SCANLON (EXECUTIVE DIRECTOR)
(208) 331-1155
Entity
Organization
Contact information
Practice address
1226 W RIVER ST, BOISE, ID 83702-7049
(208) 331-1155
(208) 383-0190
Mailing address
1226 W RIVER ST, BOISE, ID 83702-7049
(208) 331-1155
(208) 383-0190
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
4366980001
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010013347
BLUE SHIELD
ID
01
—
000010170136
REGENCE WALTERS
ID
05
—
806348400
—
ID
05
—
807850000
—
ID
01
—
8G502
BLUE CROSS
ID
Enumeration date
02/01/2007
Last updated
07/28/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up