Organization
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER
Active
Parent organization
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER
Authorized official
MR. JAMES ANGLE (CEO)
(208) 737-2101
Entity
Organization
Contact information
Practice address
801 POLELINE RD W, TWIN FALLS, ID 83301-5799
(208) 814-7459
(208) 814-7491
Mailing address
PO BOX 409, TWIN FALLS, ID 83303-0409
(208) 814-7459
(208) 814-7459
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02576
BLUE CROSS PROV NUMBER
ID
Enumeration date
06/01/2006
Last updated
05/11/2011
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