Organization
SUMMIT CARDIOVASCULAR GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY BLOEBAUM (VICE PRESIDENT, OPERATIONAL INTEGRA)
(615) 423-1159
Entity
Organization
Contact information
Practice address
8854 W EMERALD ST STE 260, BOISE, ID 83704-4860
(615) 423-1159
Mailing address
8854 W EMERALD ST STE 260, BOISE, ID 83704-4860
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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