Organization
SNAKE RIVER GASTROENTEROLOGY LABS, L.L.C.
Active
Other names
SNAKE RIVER ENDOSCOPY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WARD M.D. (PHYSICIAN)
(208) 732-3030
Entity
Organization
Contact information
Practice address
141 MORRISON ST, TWIN FALLS, ID 83301-5451
(208) 732-3030
(208) 733-8970
Mailing address
141 MORRISON ST, TWIN FALLS, ID 83301-5451
(208) 732-3030
(208) 733-8970
Taxonomy
Speciality
Code
Description
License number
State
261QE0800X
Endoscopy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806686500
—
ID
01
—
P00056475
RR MEDICARE
ID
Enumeration date
06/03/2006
Last updated
06/17/2008
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