ST LUKE'S CLINIC LLC NPI 1407283443

NPI Information

ST LUKE'S CLINIC, LLC is a rural health clinic center in Twin Falls, ID. ST LUKE'S CLINIC, LLC NPI is 1407283443. The provider is registered as an organization entity type.
The provider Is Doing Business As St Luke's Jerome Family Medicine.

The provider's business location address is:

775 POLE LINE RD W
TWIN FALLS, ID
ZIP 83301-814
Phone: (208) 814-1000

The provider's authorized official is Jeff Taylor .
The authorized official title is Sr Vp/cfo and has the following contact phone number (208) 381-2520.

The CLIA number assigned to this NPI record is 13D0520576 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 10/5/2013 and was last updated on 9/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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