SAINT ALPHONSUS CALDWELL CANCER TREATMENT CENTER LLC (NPI# 1053522961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053522961 |
Entity Type | Organization |
Organization Name | SAINT ALPHONSUS CALDWELL CANCER TREATMENT CENTER LLC |
Practice Address |
3123 Medical Dr Caldwell ID 83605-6911 |
Practice Telephone | 2084552033 |
Practice Fax Number | 2083674817 |
Mailing Telephone | 2084552033 |
Mailing Fax Number | 2083674817 |
Enumeration Date | 2007-05-24 |
Last Update Date | 2018-04-25 |
Authorized Official Name | SHELLY ANN GORMAN (MANAGER) |
Authorized Official Telephone | 2082050066 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2471R0002X |
Radiologic Technologist Specialization: Radiation Therapy |
Technologists, Technicians & Other Technical Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497899512 | Saint Alphonsus Caldwell Cancer Treatment Center LLC | Clinic/Center | 3123 Medical Drive, Caldwell, ID 83605 | 2007-02-20 |
Street Address |
3123 MEDICAL DR |
City | CALDWELL |
State | ID |
Zip Code | 83605-6911 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750797486 | Leila Khaddour | Internal Medicine | 3123 Medical Dr, Caldwell, ID 83605-6972 | 2014-07-02 |
1598956963 | Bobby Chawla | Internal Medicine | 3123 Medical Dr, Caldwell, ID 83605 | 2007-08-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518585660 | Laurie Bernstein | Occupational Therapist | 2205 Sunset Avenue, Caldwell, ID 83605 | 2020-07-06 |
1881249316 | Elevate Academy | Local Education Agency (LEA) | 114 W. Chicago St., Caldwell, ID 83605 | 2019-08-01 |
1669025359 | James Smith | Pharmacist | 2809 E Caldwell Blvd, Caldwell, ID 83605 | 2019-07-22 |
1164910824 | Michelle Stoddard | Physician Assistant | 315 E Elm St Ste 200, Caldwell, ID 83605 | 2018-04-27 |
1215430483 | Amy E Rudolf | Pharmacist | 315 E Elm St Ste 150, Caldwell, ID 83605 | 2018-03-14 |
1871044883 | Kool Ridez LLC | Case Management | 1803 Ellis Ave., Caldwell, ID 83605 | 2016-10-14 |
1932550795 | Chris Torgerson | Social Worker | 3402 Franklin Blvd, Caldwell, ID 83605 | 2016-06-23 |
1609237742 | Peggy A Mcfarland | Counselor | 534 Cleveland Suite 230, Caldwell, ID 83605 | 2016-03-17 |
1720468101 | Devin Douglas Dredge | Emergency Medicine | 1717 Arlington Ave Dept Of, Caldwell, ID 83605 | 2015-06-01 |
1578950168 | Trinidad Bridge | Licensed Practical Nurse | 2909 S. 10th Avenue, Caldwell, ID 83605 | 2015-04-21 |
Find all providers in zip 83605 |
Taxonomy Code | 2471R0002X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Radiologic Technologist |
Specialization | Radiation Therapy |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.