Provider Demographics
NPI:1326180845
Name:SALTZER MEDICAL GROUP PA
Entity Type:Organization
Organization Name:SALTZER MEDICAL GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALLOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-463-3103
Mailing Address - Street 1:217 W GEORGIA SUITE 115
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686
Mailing Address - Country:US
Mailing Address - Phone:208-463-3000
Mailing Address - Fax:208-463-3034
Practice Address - Street 1:745 S PROGRESS AVENUE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642
Practice Address - Country:US
Practice Address - Phone:208-884-2900
Practice Address - Fax:208-884-2979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies