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Organization

SIPI AMBULATORY SURGERY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE S RUE (OFFICE MANAGER)
(208) 733-3181
Entity
Organization

Contact information

Practice address
176 FALLS AVENUE, TWIN FALLS, ID 83301
(208) 733-3181
(208) 733-3168
Mailing address
176 FALLS AVENUE, TWIN FALLS, ID 83301
(208) 733-3181
(208) 733-3168

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
M7113
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010006663
REGENCE ASC
ID
01
03384
BLUE CROSS ASC
ID
05
804229000
ID
Enumeration date
08/09/2010
Last updated
11/05/2013
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