Grand Teton Surgical Center Llc

LBN: Grand Teton Surgical Center Llc
Grand Teton Surgical Center Llc is an health care organization with primary practice located at 2290 Coronado St , Idaho Falls ID 83404-7552. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Grand Teton Surgical Center Llc can be contacted via phone (208) 524-3800, or through Wellard, Teresa via phone (208) 524-3800.

Contact Information

Primary practice address
2290 Coronado St Idaho Falls ID 83404-7552
Phone: (208) 524-3800
Fax: (208) 524-3805
Website:
Map and Directions
Authorized official contact:
Name: Wellard, Teresa Registered Nurse (RN)
Phone: (208) 524-3800

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X

Profile Details

NPI number 1841295227
LBN Legal business name Grand Teton Surgical Center Llc
DBA Doing business as
Authorized official Wellard, Teresa Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2005
Last updated Mar 2nd, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841295227 NPPES
Idaho Other 03772 BLUE CROSS
Idaho Other 000010005323 BLUE CROSS
Idaho MEDICAID 805482600 BLUE CROSS

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