| Organization Name: | ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD |
| NPI Number: | 1043257736 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES ANGLE (CEO) |
| Mailing Address: | 801 Pole Line Rd W Twin Falls |
| State: | ID US |
| Postal Code: | 833015810 |
| Phone Number: | 2088147600 |
| Fax Number: | 2087372734 |
| NPI Enumeration Date: | 06/01/2006 |
| NPI Last Update Date: | 08/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |