Organization
ST ALPHONSUS REG MED
Active
Organization
ST ALPHONSUS REG MED
Active
Parent organization
ST. ALPHONSUS REG MED
Other names
DURABLE MEDICAL EQUIPMENT AND MEDICAL SUPPLIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. ALPHONSUS REG MED
Authorized official
BRIAN LANNIE CHECKETTS (CFO)
(208) 367-2844
Entity
Organization
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-3069
(208) 367-3016
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-3069
(208) 367-3016
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002267900
—
ID
Enumeration date
10/17/2006
Last updated
06/16/2025
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