LOGAN SURGERY CENTER LLC NPI 1063082980

NPI Information

NPI: 1063082980
Provider Name: LOGAN SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Specialization: Ambulatory Surgical
Entity Type: Organization
Doing Business As: INTERMOUNTAIN SURGERY CENTER - LOGAN
CLIA Number: 46D2236698
Address: 1350 N 500 E
LOGAN, UT
ZIP 84341
Phone: (435) 363-9265

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NPI Details

LOGAN SURGERY CENTER, LLC is an ambulatory surgical clinic center in Logan, UT. LOGAN SURGERY CENTER, LLC NPI is 1063082980. The provider is registered as an organization entity type.
The provider Is Doing Business As Intermountain Surgery Center - Logan.

The provider's business location address is:

1350 N 500 E
LOGAN, UT
ZIP 84341-400
Phone: (435) 363-9265

The provider's authorized official is Brandon Mcbride .
The authorized official title is Administrator and has the following contact phone number (435) 890-0263.

The CLIA number assigned to this NPI record is 46D2236698 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/1/2021 and was last updated on 3/11/2024.

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			Yes

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: 11/21/2025

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