Idaho Endoscopy Center Llc

LBN: Idaho Endoscopy Center Llc
Idaho Endoscopy Center Llc is an health care organization with primary practice located at 6259 W Emerald St , Boise ID 83704-8731. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty. Idaho Endoscopy Center Llc can be contacted via phone (208) 489-1900, or through Mallory, Mark A via phone (208) 489-1900.

Contact Information

Primary practice address
6259 W Emerald St Boise ID 83704-8731
Phone: (208) 489-1900
Fax: (208) 489-1929
Website:
Map and Directions
Authorized official contact:
Name: Mallory, Mark A Doctor of Medicine (MD)
Phone: (208) 489-1900

Health care specialties

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

Profile Details

NPI number 1750616249
LBN Legal business name Idaho Endoscopy Center Llc
DBA Doing business as
Authorized official Mallory, Mark A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 16th, 2009
Last updated Jul 23rd, 2020 - about 5 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 1750616249 NPPES
Idaho Other 1871902 MEDICARE PTAN

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