Organization
ST LUKES REGIONAL MEDICAL CENTER
Active
Other names
St Lukes Hemophilia Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF TAYLOR (SYSTEM VP CFO)
(208) 381-2520
Entity
Organization
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2222
Mailing address
PO BOX 640, BOISE, ID 83701-0640
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
03
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03
STATE LIC #
ID
Enumeration date
03/05/2007
Last updated
09/30/2016
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