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Contact Information

ST LUKES CLINIC-TREASURE VALLEY LLC
840 N 4TH E
MOUNTAIN HOME, ID83647-2166
 Phone: 208-587-1850
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for ST LUKES CLINIC TREASURE VALLEY LLC · (Female)

NPI Number 1417297821
Status Active
Credentials
Entity Individual
Enumeration date 02/21/2013
Last updated 04/23/2026 - About 1 months ago
Sole proprietor 1 Not specified
Identifiers
  • ID Other 1369110 MEDICARE / MULTI SPECIALTY CLINIC
  • ID Other 133999 MEDICARE / RHC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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