Sunrise Ketamine Clinic Llc

LBN: Sunrise Ketamine Clinic Llc
Sunrise Ketamine Clinic Llc is an health care organization with primary practice located at 3555 Potomac Way Ste B , Idaho Falls ID 83404-4985. 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. Sunrise Ketamine Clinic Llc can be contacted via phone (208) 524-9080, or through Merkley, Bryan Todd via phone (208) 520-0527.

Contact Information

Primary practice address
3555 Potomac Way Ste B Idaho Falls ID 83404-4985
Phone: (208) 524-9080
Fax: (208) 529-3786
Website:
Map and Directions
Authorized official contact:
Name: Merkley, Bryan Todd Certified Registered Nurse Anesthetist (CRNA)
Phone: (208) 520-0527

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X

Profile Details

NPI number 1205598398
LBN Legal business name Sunrise Ketamine Clinic Llc
DBA Doing business as
Authorized official Merkley, Bryan Todd Certified Registered Nurse Anesthetist (CRNA)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 6th, 2021
Last updated Oct 6th, 2021 - about 3 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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