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Organization
IDAHO SURGERY CENTER, LLC
Active
Organization
IDAHO SURGERY CENTER, LLC
Active
Other names
Idaho Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY HOGUE (BUSINESS OFFICE MANAGER)
(208) 453-8668
Entity
Organization
Contact information
Practice address
3115 MEDICAL DRIVE, CALDWELL, ID 83605-6972
(208) 453-8668
(208) 453-8448
Mailing address
3115 MEDICAL DRIVE, CALDWELL, ID 83605-6972
(208) 453-8668
(208) 453-8448
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807417200
—
ID
Enumeration date
01/23/2006
Last updated
08/31/2011
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