Idaho Falls Surgical Center
LBN: Idaho Falls Surgical Center
Idaho Falls Surgical Center 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 Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as the primary health care specialty.
Idaho Falls Surgical 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:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X |
Profile Details
| NPI number | 1952568099 |
|---|---|
| LBN Legal business name | Idaho Falls Surgical Center |
| DBA Doing business as | |
| Authorized official | Petersen, Mark L. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 16th, 2008 |
| Last updated | May 16th, 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 | 1952568099 | NPPES |
| Other | DB0412 | RAILROAD MEDICARE | |
| MEDICAID | 806687900 | RAILROAD MEDICARE |
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