Organization
GROVE CITY ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BLAKE G PURCELL CRNA (PRES)
(208) 313-0175
Entity
Organization
Contact information
Practice address
1485 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-5100
Mailing address
PO BOX 2193, IDAHO FALLS, ID 83403-2193
(208) 552-8777
(208) 523-2025
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/21/2011
Last updated
12/09/2016
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