SUNNYSIDE SURGERY CENTER LLC NPI 1285825075

NPI Information

SUNNYSIDE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Idaho Falls, ID. SUNNYSIDE SURGERY CENTER, LLC NPI is 1285825075. The provider is registered as an organization entity type.

The provider's business location address is:

3345 S HOLMES AVE STE B
IDAHO FALLS, ID
ZIP 83404-981
Phone: (208) 528-2858
Fax: (208) 528-8022

The provider's authorized official is Michael K James .
The authorized official title is Owner and has the following contact phone number (208) 528-2858.

The CLIA number assigned to this NPI record is 13D1049032 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/6/2007 and was last updated on 8/6/2007.

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:

Other Identifiers

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