Basic Information
Provider Information
NPI: 1477695617
EntityType: 2
ReplacementNPI:  
OrganizationName: SALTZER MEDICAL GROUP PA
LastName:  
FirstName:  
MiddleName:  
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Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
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Mailing Information
Address1: 217 W GEORGIA
Address2: SUITE 115
City: NAMPA
State: ID
PostalCode: 83686
CountryCode: US
TelephoneNumber: 2084633000
FaxNumber: 2084633034
Practice Location
Address1: 210 W GEORGIA AVENUE
Address2:  
City: NAMPA
State: ID
PostalCode: 83686
CountryCode: US
TelephoneNumber: 2084633000
FaxNumber: 2084633034
Other Information
ProviderEnumerationDate: 02/13/2007
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SAVAGE
AuthorizedOfficialFirstName: WILLIAM
AuthorizedOfficialMiddleName: E
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 2084633000
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


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