Organization
ST. JOSEPH REGIONAL MEDICAL CENTER
Active
Other names
ST. JOSEPH REGIONAL MEDICAL CENTER PHYSICIANS
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBURN (DIRECTOR OF BUSINESS SERVICES)
(208) 799-5200
Entity
Organization
Contact information
Practice address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
(208) 799-5554
Mailing address
415 6TH ST, LEWISTON, ID 83501-2431
(208) 743-2511
(208) 799-5554
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
ID
207P00000X
Emergency Medicine Physician
Primary
—
ID
207RH0003X
Hematology & Oncology Physician
—
ID
2084P0800X
Psychiatry Physician
—
ID
363A00000X
Physician Assistant
—
ID
363L00000X
Nurse Practitioner
—
ID
364S00000X
Clinical Nurse Specialist
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005404
REGENCE OF IDAHO
ID
01
—
000010005405
REGENCE OF IDAHO
ID
01
—
000010005407
REGENCE OF IDAHO
ID
05
—
7045891
—
WA
05
—
7046279
—
WA
05
—
7046543
—
WA
01
—
8C576
BLUE CROSS OF IDAHO
ID
01
—
8K552
BLUE CROSS OF IDAHO
ID
Enumeration date
03/08/2007
Last updated
11/05/2007
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