Organization
IDAHO ENDOSCOPY CENTER LLC
Active
Parent organization
IDAHO ENDOSCOPY CENTER LLC
Other names
Nampa Idaho Endoscopy Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
IDAHO ENDOSCOPY CENTER LLC
Authorized official
MARK A MALLORY MD (MANAGER)
(208) 489-1900
Entity
Organization
Contact information
Practice address
5080 E COMMERCE ST, NAMPA, ID 83687-5513
(986) 867-1600
(986) 867-1601
Mailing address
6259 W EMERALD ST, BOISE, ID 83704-8731
(208) 489-1900
(208) 489-1929
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/09/2020
Last updated
07/30/2020
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