Idaho Surgicenter South

LBN: Idaho Surgicenter Inc
Idaho Surgicenter South is an health care organization with primary practice located at 1157 Call Place , Pocatello ID 83201. The organization recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Ambulatory Health Care Facilities / Ambulatory Surgical, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Ambulatory Surgical is the primary health care specialty. Idaho Surgicenter Inc can be contacted via phone (208) 238-6337, or through Barnard, Sean via phone (208) 852-6242.

Contact Information

Primary practice address
1157 Call Place Pocatello ID 83201
Phone: (208) 238-6337
Fax: (208) 776-5510
Website:
Map and Directions
Authorized official contact:
Name: Barnard, Sean
Phone: (208) 852-6242

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X P166 Idaho
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X P92 Idaho
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X P153 Idaho
Ambulatory Health Care Facilities / Ambulatory Surgical 261QA1903X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1992759930
LBN Legal business name Idaho Surgicenter Inc
DBA Doing business as Idaho Surgicenter South
Authorized official Barnard, Sean
Entity Organization
Organization subpart 1 No
Enumeration date May 22nd, 2006
Last updated Jan 31st, 2022 - about 2 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 1992759930 NPPES
Idaho Other 000010027108 BLUE SHIELD
Idaho MEDICAID 805730900 BLUE SHIELD
Idaho Other P00091636 BLUE SHIELD
Idaho Other 03913 BLUE SHIELD
Idaho MEDICAID 807288200 BLUE SHIELD

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