Idaho Falls Surgical Center Asc

LBN: Idaho Falls Surcigal Center
Idaho Falls Surgical Center Asc is an health care organization with primary practice located at 1945 E 17Th St , Idaho Falls ID 83404-6429. 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 Falls Surcigal Center can be contacted via phone (208) 529-1945, or through Petersen, Mark L via phone (208) 529-1945.

Contact Information

Primary practice address
1945 E 17Th St Idaho Falls ID 83404-6429
Phone: (208) 529-1945
Fax: (208) 529-1961
Website:
Map and Directions
Authorized official contact:
Name: Petersen, Mark L Doctor of Medicine (MD)
Phone: (208) 529-1945

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X 13-C0001000 Idaho

Profile Details

NPI number 1053481218
LBN Legal business name Idaho Falls Surcigal Center
DBA Doing business as Idaho Falls Surgical Center Asc
Authorized official Petersen, Mark L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 8th, 2006
Last updated Jun 9th, 2008 - about 18 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 1053481218 NPPES
Other 490000095 RAILROAD MEDICARE
MEDICAID 002512900 RAILROAD MEDICARE

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