Organization
ST LUKES REGIONAL MEDICAL CENTER
Active
Other names
ST LUKES INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE LYNNE COWGILL (CREDENTIALING COORDINATOR)
(208) 381-4137
Entity
Organization
Contact information
Practice address
520 S EAGLE RD, SUITE 3102, MERIDIAN, ID 83642-6351
(208) 706-5100
(208) 706-5169
Mailing address
PO BOX 550, BOISE, ID 83701-0550
(208) 706-5100
(208) 706-5169
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2006
Last updated
08/22/2020
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