Organization
INTERMOUNTAIN SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRANDI BARNHART (BILLING COORDINATOR)
(208) 489-4206
Entity
Organization
Contact information
Practice address
600 N ROBBINS RD, STE 401, BOISE, ID 83702
(208) 383-0201
(208) 489-4010
Mailing address
600 ROBBINS RD, STE 401, BOISE, ID 83702-4539
(208) 383-0201
(208) 489-4300
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010028431
BLUE SHIELD
ID
01
—
04077
BLUE CROSS
ID
01
—
185507800
US DEPT OF LABOR
ID
01
—
490005004
MEDICARE RAILROAD
ID
05
—
805845600
—
ID
Enumeration date
08/23/2006
Last updated
10/28/2008
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