Saint Alphonsus Nephrology Center

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Ontario, OR

NPI 1073504635 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1073504635
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
170009 (OR)
Legal business name
SAINT ALPHONSUS NEPHROLOGY CENTER
Practice address
515 East LN
Ontario, OR 97914-3953
Phone
(541) 889-9557
Fax
(541) 881-8721
NPI assigned
Nov 2, 2005
Organization subpart
No

Authorized official

Name
Jan M Jacobs
Title
Accounts Receivable Manager
Phone
(208) 367-3076

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Saint Alphonsus Nephrology Center (5 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 170009 OR Yes

Addresses

Primary practice location

515 East LN
Ontario, OR 97914-3953

Mailing address

5610 Gage St
Ste B
Boise, ID 83706-1349
Phone (208) 367-3076

Other providers in Ontario, OR

All providers in Ontario, OR · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oregon

Sources for this page

Verify at the official NPI Registry.