Organization
TEN MILE SURGERY CENTER, LLC
Active
Other names
Ten Mile Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BLOXHAM (ADMINISTRATOR)
(208) 302-7960
Entity
Organization
Contact information
Practice address
875 S VANGUARD WAY, MERIDIAN, ID 83642-7552
(208) 960-0870
Mailing address
875 S VANGUARD WAY STE 120, MERIDIAN, ID 83642-8541
(208) 302-7960
(208) 302-7999
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/17/2020
Last updated
05/14/2025
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