Provider Demographics
NPI:1336839562
Name:SOUTHERN IDAHO HEALTH PARTNERS DBA SALTZER CLINICS
Entity Type:Organization
Organization Name:SOUTHERN IDAHO HEALTH PARTNERS DBA SALTZER CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:COLLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:COSSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-463-3244
Mailing Address - Street 1:215 E HAWAII AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-6011
Mailing Address - Country:US
Mailing Address - Phone:208-463-3244
Mailing Address - Fax:
Practice Address - Street 1:875 S VANGUARD WAY STE 200
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-8542
Practice Address - Country:US
Practice Address - Phone:208-463-3244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN IDAHO HEALTH PARTNERS DBA SALTZER CLINICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport