KOOTENAI OUTPATIENT SURGERY CNTR LLC NPI 1740289024

NPI Information

NPI: 1740289024
Provider Name: KOOTENAI OUTPATIENT SURGERY CNTR LLC

Doing Business As: KOOTENAI OUTPATIENT SURGERY

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
707 W IRONWOOD DR
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 625-6400
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KOOTENAI OUTPATIENT SURGERY CNTR LLC is an ambulatory surgical clinic center in Coeur D Alene, ID. KOOTENAI OUTPATIENT SURGERY CNTR LLC NPI is 1740289024. The provider is registered as an organization entity type.
The provider Is Doing Business As Kootenai Outpatient Surgery.

The provider's business location address is:

707 W IRONWOOD DR
COEUR D ALENE, ID
ZIP 83814-772
Phone: (208) 625-6400
Fax: (208) 625-6401

The provider's authorized official is Shirley M Torwirt .
The authorized official title is Director and has the following contact phone number (208) 625-6428.

The enumeration date for this NPI number is 7/19/2005 and was last updated on 4/13/2022.

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	332B00000X	Durable Medical Equipment & Medical Supplies		307824	IDAHO	No
2	261QA1903X	Clinic/Center	Ambulatory Surgical	307824	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	805910000	MEDICAID	IDAHO
2	000010029201	OTHER	IDAHO	REGENCE BS
3	04069	OTHER	IDAHO	BCBS

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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