Organization
IDAHO SURGERY CENTER, LLC
Active
Other names
Idaho Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY HOGUE (BUSINESS OFFICE MANAGER)
(208) 453-8668
Entity
Organization
Contact information
Practice address
3115 MEDICAL DRIVE, CALDWELL, ID 83605-6972
(208) 453-8668
(208) 453-8448
Mailing address
3115 MEDICAL DRIVE, CALDWELL, ID 83605-6972
(208) 453-8668
(208) 453-8448
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807417200
—
ID
Enumeration date
01/23/2006
Last updated
08/31/2011
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