PORTNEUF ASC LLC NPI 1871016071

NPI Information

NPI: 1871016071
Provider Name: PORTNEUF ASC, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 13D0520361

Address:
1151 HOSPITAL WAY BLDG A
POCATELLO, ID
ZIP 83201
Phone: (208) 232-6616
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PORTNEUF ASC, LLC is an ambulatory surgical clinic center in Pocatello, ID. PORTNEUF ASC, LLC NPI is 1871016071. The provider is registered as an organization entity type.

The provider's business location address is:

1151 HOSPITAL WAY BLDG A
POCATELLO, ID
ZIP 83201-091
Phone: (208) 232-6616
Fax: (208) 232-6618

The provider's authorized official is Stephen C Petrovich .
The authorized official title is Evp and has the following contact phone number (615) 296-3000.

The CLIA number assigned to this NPI record is 13D0520361 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 7/19/2017 and was last updated on 7/19/2017.

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			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: 11/14/2023

NPI Synchronization or Removal

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