Surgicare Center Of Idaho, Llc
LBN: Surgicare Center Of Idaho, Llc
Surgicare Center Of Idaho, Llc is an health care organization with primary practice located at 360 E Mallard Dr Ste 125, Boise ID 83706-3941. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Ambulatory Surgical, Ambulatory Health Care Facilities / Ophthalmologic Surgery. Ambulatory Health Care Facilities / Ambulatory Surgical is the primary health care specialty.
Surgicare Center Of Idaho, Llc can be contacted via phone (208) 336-8700, or through Pennow, Louis via phone (208) 336-8700.
Contact Information
Primary practice address
360 E Mallard Dr Ste 125
Boise ID 83706-3941
Phone: (208) 336-8700
Fax: (208) 426-0902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | ||
| Ambulatory Health Care Facilities / Ophthalmologic Surgery | 261QS0132X |
Profile Details
| NPI number | 1114923471 |
|---|---|
| LBN Legal business name | Surgicare Center Of Idaho, Llc |
| DBA Doing business as | |
| Authorized official | Pennow, Louis MBA |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 22nd, 2005 |
| Last updated | Oct 10th, 2016 - about 9 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 | 1114923471 | NPPES |
| Idaho | MEDICAID | 273390 |
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