GRANGE SURGERY CENTER PLLC NPI 1316663032

NPI Information

NPI: 1316663032
Provider Name: GRANGE SURGERY CENTER PLLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
450 W STATE ST STE 250
EAGLE, ID
ZIP 83616
Phone: (208) 506-7966
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GRANGE SURGERY CENTER PLLC is an ambulatory surgical clinic center in Eagle, ID. GRANGE SURGERY CENTER PLLC NPI is 1316663032. The provider is registered as an organization entity type.

The provider's business location address is:

450 W STATE ST STE 250
EAGLE, ID
ZIP 83616-974
Phone: (208) 506-7966

The provider's authorized official is Landon Grange .
The authorized official title is Medical Director and has the following contact phone number (208) 506-7966.

The enumeration date for this NPI number is 10/14/2022 and was last updated on 8/22/2023.

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	261QS0132X	Clinic/Center	Ophthalmologic Surgery			No
2	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: 5/5/2024

NPI Synchronization or Removal

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