NPIMap

Organization Active NPI

St Lukes Regional Medical Center

  • Pharmacy
  • Boise, ID
National Provider Identifier
1871218552
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Practice address
4840 N Cloverdale Rd Ste P
Boise, ID 83713-2423
Phone
(208) 706-8170
Fax
(208) 706-8171
NPI assigned
Oct 5, 2022
Organization subpart
Yes
Parent organization
ST LUKES HEALTH SYSTEM LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelley Curtis
Title
Chief Pharmacy Officer
Phone
(208) 493-2307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

4840 N Cloverdale Rd Ste P
Boise, ID 83713-2423

Mailing address

PO Box 640
Boise, ID 83701-0640
Phone (208) 205-7779

Other identifiers 1

IdentifierTypeStateIssuer
NPIMedicaidID

Other names 1

  • St Lukes Pharmacy - Cloverdale Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211005002801 ID Part B Supplier - Pharmacy 5799692604 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boise, ID; Fruitland, ID; Meridian, ID; Nampa, ID
O20230803001835 ID DME Supplier - Pharmacy 5799692604 Practice locations: Boise, ID

Other NPIs with the same Medicare PAC ID 14

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 14

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
St Lukes Pharmacy - Cloverdale4840 N Cloverdale Rd, Boise, ID 83713-2423(208) 706-8170 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Oct 1, 1984

National Provider Directory

National Provider Directory
Tax ID family
Richard H Lane MD50 organizations share this tax ID, including this one
Part of
St Luke'S Children'S

Other organizations with this tax ID 49

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

View all 49

Locations

4840 N Cloverdale Rd
Ste P
Boise, ID 83713
Phone (208) 706-8170

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St Lukes Rehabilitation Inpatient Acute Care UnitBoise, ID, CCN 13T006 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2014
St Lukes Clinic - Eastern Oregan Medical AssociatesBaker City, OR, CCN 383852 Rural health clinic 5% Or Greater Direct Ownership Interest Sep 1, 2016
St Lukes Clinic-Trinity Mountain MedicalMountain Home, ID, CCN 133999 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2016

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1871218552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837010640",
            "telephone_number": "208-205-7779",
            "fax_number": "208-205-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 N CLOVERDALE RD STE P",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132423",
            "telephone_number": "208-706-8170",
            "fax_number": "208-706-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST LUKES HEALTH SYSTEM LTD",
        "enumeration_date": "2022-10-05",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "208-493-2307"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NPI",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "St Lukes Pharmacy - Cloverdale",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Lukes Pharmacy - Cloverdale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.