# BOISE ENDOSCOPY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BOISE ENDOSCOPY CENTER, LLC
- **Other names:** dba Meridian Endoscopy Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912992900
- **Legal business name:** BOISE ENDOSCOPY CENTER, LLC
- **Authorized official:** TYE MCCOUBREY (DIRECTOR OF H.R.)
- **Authorized official phone:** (208) 343-6458

## Contact information

- **Practice address:** 2235 E GALA ST, MERIDIAN, ID 83642-7090
- **Practice address phone:** (208) 695-2100
- **Practice address fax:** (208) 695-2110
- **Mailing address:** 425 W BANNOCK ST, BOISE, ID 83702-6035
- **Mailing address phone:** (208) 343-6458
- **Mailing address fax:** (208) 343-5031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 13-C0001057 | ID | Yes |

## Other

- **Enumeration date:** 09/15/2005
- **Last updated:** 09/22/2026