Organization
IDAHO FALLS ASC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NED W HILLYARD (CCO)
(208) 557-2711
Entity
Organization
Contact information
Practice address
3302 VALENCIA DRIVE, SUITE 101A, IDAHO FALLS, ID 83404
(208) 557-4525
(208) 542-4280
Mailing address
3302 VALENCIA DR STE 101A, IDAHO FALLS, ID 83404-7068
(208) 557-4525
(208) 542-4280
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/05/2018
Last updated
01/23/2023
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