CREEKSIDE SURGERY CENTER LLC NPI 1275634826

NPI Information

NPI: 1275634826
Provider Name: CREEKSIDE SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
2375 E SUNNYSIDE RD
SUITE B
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 524-0610
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CREEKSIDE SURGERY CENTER LLC is an ambulatory surgical clinic center in Idaho Falls, ID. CREEKSIDE SURGERY CENTER LLC NPI is 1275634826. The provider is registered as an organization entity type.

The provider's business location address is:

2375 E SUNNYSIDE RD
SUITE B
IDAHO FALLS, ID
ZIP 83404-280
Phone: (208) 524-0610
Fax: (208) 557-0171

The provider's authorized official is Catherine L Linderman .
The authorized official title is Owner and has the following contact phone number (208) 524-0610.

The enumeration date for this NPI number is 9/26/2006 and was last updated on 6/25/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical		IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	806782200	MEDICAID	IDAHO
2	1870591	MEDICARE ID-TYPE UNSPECIFIED	IDAHO	MEDICARE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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