Organization · Type 2 NPI

ST Lukes Regional Medical Center

Radiation Oncology Clinic/Center · Fruitland, ID

NPI number 1417870882 Active

Practice location

1118 NW 16th St Ste D
Fruitland, ID 83619-2272

Specialties and licenses

Taxonomy	Code	License
Radiation Oncology Clinic/Center Primary	261QX0203X	None listed

Radiation Oncology Clinic/Center: Definition to come...

5 other providers at this address

NPI record

NPI: 1417870882
Entity type: Organization (Type 2)
Issued: Aug 3, 2026
Last updated: Aug 3, 2026
Status: Active
Subpart: Yes of ST Lukes Health System Ltd

Other names

ST Lukes Cancer Institute - Fruitland · doing business as

Authorized official

Jacob Paul Reid
PFS Administration; Sr. Director
(208) 706-7665

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About NPI 1417870882

ST Lukes Regional Medical Center's National Provider Identifier is 1417870882, issued on Aug 3, 2026. The primary taxonomy on file is Radiation Oncology Clinic/Center (261QX0203X), and the practice location is in Fruitland, ID. The record was last updated on Aug 3, 2026.