PARKWAY SURGERY CENTER LLC NPI 1275645574

NPI Information

NPI: 1275645574
Provider Name: PARKWAY SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1485 PARKWAY DR
BLACKFOOT, ID
ZIP 83221
Phone: (208) 785-5100
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PARKWAY SURGERY CENTER LLC is an ambulatory surgical clinic center in Blackfoot, ID. PARKWAY SURGERY CENTER LLC NPI is 1275645574. The provider is registered as an organization entity type.

The provider's business location address is:

1485 PARKWAY DR
BLACKFOOT, ID
ZIP 83221-667
Phone: (208) 785-5100
Fax: (208) 785-5112

The provider's authorized official is Robert J Lee .
The authorized official title is Co Manager and has the following contact phone number (208) 522-4409.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 7/12/2013.

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	1275645574	MEDICAID	IDAHO
2	1870428	MEDICARE ID-TYPE UNSPECIFIED	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

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