ST LUKES CLINIC - TREASURE VALLEY LLC (NPI# 1871835538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871835538 |
| Entity Type | Organization |
| Organization Name | ST LUKES CLINIC - TREASURE VALLEY LLC |
| Other Organization Name | ST LUKES EOMA DME |
| Practice Address |
3950 17th St Baker City OR 97814-1300 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 5415231001 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |
| Authorized Official Name | JEFFREY TAYLOR (CFO) |
| Authorized Official Telephone | 2083812520 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST LUKES REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 03 | ID | Suppliers |
| Other Name | Type Code |
|---|---|
| St Lukes EOMA DME | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861982456 | St Lukes Clinic - Treasure Valley LLC | Preventive Medicine | 5155 S Howry Lane, Meridian, ID 83642 | 2018-05-18 |
| 1326336058 | St Lukes Clinic - Treasure Valley LLC | Emergency Medicine | 190 E Bannock St, Boise, ID 83712-6241 | 2011-07-15 |
| Street Address |
3950 17TH ST |
| City | BAKER CITY |
| State | OR |
| Zip Code | 97814-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427046820 | J Daniel Smithson | Family Medicine | 3950 17th St, Suite A, Baker City, OR 97814-1300 | 2005-10-10 |
| 1073089298 | Laura Van Duker | Physician Assistant | 3950 17th St, Baker City, OR 97814-1300 | 2018-10-15 |
| 1487046785 | Colleen M Mcdonald | Social Worker | 3950 17th St, Baker City, OR 97814-1300 | 2015-02-23 |
| 1982009817 | Micah Thayn | Physician Assistant | 3950 17th St, Baker City, OR 97814-1300 | 2014-11-04 |
| 1023430493 | Lauren Zink | Dietitian, Registered | 3950 17th St, St # A, Baker City, OR 97814-1300 | 2014-01-20 |
| 1508113366 | Devin S Bowman | Physician Assistant | 3950 17th St, Suite A, Baker City, OR 97814-1300 | 2012-08-12 |
| 1427348507 | Neil J Carroll | Family Medicine | 3950 17th St, Baker City, OR 97814-1300 | 2011-04-11 |
| 1336442607 | St Lukes Clinic-treasure Valley LLC | Family Medicine | 3950 17th St, Baker City, OR 97814-1300 | 2010-12-08 |
| 1437486875 | Monte W. Anderson | Physician Assistant | 3950 17th St, Ste A, Baker City, OR 97814-1300 | 2009-11-05 |
| 1487730479 | Karen C Andruss | Nurse Practitioner | 3950 17th St, Suite A, Baker City, OR 97814-1300 | 2006-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083279871 | Charles Henry Campos | Counselor | 2021 Court Street, Baker City, OR 97814 | 2019-05-07 |
| 1831546217 | Veronica Crowder | Physician Assistant | Samg Orthopedics Baker City, 3325 Pocahontas Rd, Baker City, OR 97814 | 2016-05-16 |
| 1013389956 | Dara Michelle Fields | Counselor | 2200 4th Street, Baker City, OR 97814 | 2015-10-29 |
| 1003223694 | Colleen Davenport | Nurse Practitioner | 3975 N Midway Dr, Baker City, OR 97814 | 2014-07-16 |
| 1629418363 | Sherry Melena Zacharias Forsyth | Counselor | 2100 Main St., New Directions, Baker City, OR 97814 | 2013-06-26 |
| 1609215573 | Logan Clay Frederickson | Family Medicine | 3820 17th Street, Baker City, OR 97814 | 2013-06-24 |
| 1790124485 | James Lee Morris | Counselor | 3610 Midway, Baker City, OR 97814 | 2013-06-17 |
| 1881955656 | New Directions Northwest, Inc | Substance Abuse Rehabilitation Facility | 3610 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1972864759 | New Directions Northwest, Inc. | Substance Abuse Rehabilitation Facility | 3700 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1659671113 | Al H Brickman | Pharmacist | 1205 Campbell St., Baker City, OR 97814 | 2010-10-29 |
| Find all providers in zip 97814 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689034837 | Norco, Inc | Durable Medical Equipment & Medical Supplies | 1515 Campbell St, Baker City, OR 97814-2150 | 2016-03-01 |
| 1467561753 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 1217 Campbell Street, Baker City, OR 97814-2221 | 2006-08-30 |
| 1427081785 | Bimart Corporation | Durable Medical Equipment & Medical Supplies | 700 Campbell St, Baker City, OR 97814-2212 | 2006-07-09 |
| 1912943770 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 1205 Campbell St, Baker City, OR 97814-2271 | 2006-06-21 |
| 1417089830 | St. Elizabeth Health Services, Inc. | Durable Medical Equipment & Medical Supplies | 3325 Pocahontas Rd, Baker City, OR 97814-1464 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959272 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 281 Laclair St Rm 135, Coos Bay, OR 97420-2988 | 2020-10-14 |
| 1730794181 | Wound Pros Oregon | Durable Medical Equipment & Medical Supplies | 10260 Sw Greenburg Road 4th Floor, Portland, OR 97223-5500 | 2020-09-12 |
| 1881209385 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12555 Nw Cornell Rd, Portland, OR 97229-5683 | 2020-09-11 |
| 1902423676 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 Se Court Pl Ste P, Pendleton, OR 97801-3281 | 2020-06-29 |
| 1851914618 | Bellevue Healthcare II Inc | Durable Medical Equipment & Medical Supplies | 61580 American Ln, Bend, OR 97702-9792 | 2020-05-27 |
| 1538799333 | Big Creek Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 1664 N Coast Hwy, Newport, OR 97365 | 2020-01-21 |
| 1184260325 | Pacific O&p LLC | Durable Medical Equipment & Medical Supplies | 1050 Sw 6th Ave Ste 1100, Portland, OR 97204-1153 | 2019-11-22 |
| 1790335073 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 621 W Madrone St Ste P1, Roseburg, OR 97470-3090 | 2019-09-18 |
| 1386294379 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8145 Se 17th Ave, Portland, OR 97202-6718 | 2019-09-12 |
| 1346899721 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 345 Sw Harrison St, Portland, OR 97201-5364 | 2019-09-09 |
| Find all providers with the same taxonomy | ||||
| City | BAKER CITY |
| Zip Code | 97814 |
Please comment or provide details below to improve the information on ST LUKES CLINIC - TREASURE VALLEY LLC.
| 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.