Organization Name: | SAINT ALPHONSUS CALDWELL CANCER TREATMENT CENTER LLC |
NPI Number: | 1053522961 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TAMMY STEWART (SUPERVISOR) |
Mailing Address: | 3123 Medical Dr Caldwell |
State: | ID US |
Postal Code: | 836056911 |
Phone Number: | 2084552033 |
Fax Number: | 2083674817 |
NPI Enumeration Date: | 05/24/2007 |
NPI Last Update Date: | 09/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2471R0002X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | Radiation Therapy |
Taxonomy Definition: |