Idaho Eye Surgicenter
LBN: Idaho Eye Center Pa
Idaho Eye Surgicenter is an health care organization with primary practice located at 2025 E 17Th St , Idaho Falls ID 83404. 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 Eye Center Pa can be contacted via phone (208) 524-2025, or through Gardner, Bradley P via phone (208) 524-2025.
Contact Information
Primary practice address
2025 E 17Th St
Idaho Falls ID 83404
Phone: (208) 524-2025
Fax: (208) 529-1924
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X |
Profile Details
| NPI number | 1629145685 |
|---|---|
| LBN Legal business name | Idaho Eye Center Pa |
| DBA Doing business as | Idaho Eye Surgicenter |
| Authorized official | Gardner, Bradley P Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Aug 12th, 2008 - about 16 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 | 1629145685 | NPPES |
| Idaho | Other | 490000614 | RAILROAD MEDICARE |
| Idaho | Other | 480000614 | RAILROAD MEDICARE |
| Idaho | Other | 00984 | RAILROAD MEDICARE |
| Idaho | MEDICAID | 002562201 | RAILROAD MEDICARE |
| Idaho | MEDICAID | 002565200 | RAILROAD MEDICARE |
| Idaho | Other | 105947500 | RAILROAD MEDICARE |
| Idaho | Other | 5207 | RAILROAD MEDICARE |
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