BOISE ENDOSCOPY CENTER LLC NPI 1114912102

NPI Information

NPI: 1114912102
Provider Name: BOISE ENDOSCOPY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
425 W BANNOCK ST
BOISE, ID
ZIP 83702
Phone: (208) 342-7169
Get Directions

BOISE ENDOSCOPY CENTER, LLC is an ambulatory surgical clinic center in Boise, ID. BOISE ENDOSCOPY CENTER, LLC NPI is 1114912102. The provider is registered as an organization entity type.

The provider's business location address is:

425 W BANNOCK ST
BOISE, ID
ZIP 83702-035
Phone: (208) 342-7169
Fax: (208) 368-0863

The provider's authorized official is Rebecca Pahssen .
The authorized official title is Credentialing Manager and has the following contact phone number (208) 489-1431.

The enumeration date for this NPI number is 9/15/2005 and was last updated on 12/8/2022.

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	1870273	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	000010005291	OTHER	IDAHO	BLUE SHIELD OF IDAHO
2	04580	OTHER	IDAHO	BLUE CROSS OF IDAHO
3	805944300	MEDICAID	IDAHO

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: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »