Organization
SAINT ALPHONSUS PHYSICIAN SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANELLE G. REILLY (PRESIDENT)
(208) 367-6490
Entity
Organization
Contact information
Practice address
315 E ELM ST, SUITE 100, CALDWELL, ID 83605-4858
(208) 459-7415
(208) 453-3232
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805403600
—
ID
05
—
805418900
—
ID
Enumeration date
05/12/2006
Last updated
10/09/2008
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