BOISE ENDOSCOPY CENTER, LLC
Surgery Yellow Pages
Boise, Idaho
Provider NPI: 1114912102
Organization Information:Organization Name: BOISE ENDOSCOPY CENTER, LLC
Practice Location:
425 W BANNOCK ST BOISE, ID 83702 US
Tel: 208-342-7169 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
425 W BANNOCK ST BOISE, ID 83702 US
Tel: 208-342-7169 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical | ID | 1870273 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
BLUE SHIELD OF IDAHO | 000010005291 | ID | 01 |
BLUE CROSS OF IDAHO | 04580 | ID | 01 |
805944300 | ID | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin