Ambulatory Surgery Center Of Burley, Llc
LBN: Ambulatory Surgery Center Of Burley, Llc
Ambulatory Surgery Center Of Burley, Llc is an health care organization with primary practice located at 1344 Hiland Ave Suite E, Burley ID 83318-1564. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Ambulatory Surgical, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Ambulatory Health Care Facilities / Ambulatory Surgical is the primary health care specialty.
Ambulatory Surgery Center Of Burley, Llc can be contacted via phone (208) 677-8888, or through Petersen, Joseph R. via phone (208) 677-8888.
Contact Information
Primary practice address
1344 Hiland Ave Suite E
Burley ID 83318-1564
Phone: (208) 677-8888
Fax: (208) 678-5833
Website:
Authorized official contact:
Name: Petersen, Joseph R. Doctor of Medicine (MD)
Phone: (208) 677-8888
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X |
Profile Details
| NPI number | 1992706840 |
|---|---|
| LBN Legal business name | Ambulatory Surgery Center Of Burley, Llc |
| DBA Doing business as | |
| Authorized official | Petersen, Joseph R. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Aug 17th, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992706840 | NPPES |
| Idaho | MEDICAID | 805534000 | |
| Idaho | Other | 24973 000010005417 | |
| Idaho | Other | 03822 |
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