Organization
ST LUKES CLINIC - TREASURE VALLEY LLC
Active
Parent organization
ST LUKES REGIONAL MEDICAL CENTER
Other names
St Lukes EOMA DME
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Authorized official
JEFFREY TAYLOR (CFO)
(208) 381-2520
Entity
Organization
Contact information
Practice address
3950 17TH ST, BAKER CITY, OR 97814-1300
(541) 523-1001
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
03
ID
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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