LEWIS & CLARK ORTHOPAEDIC INSTITUTE LLC
Surgery Yellow Pages
Lewiston, Idaho
Provider NPI: 1922093293
Organization Information:Organization Name: LEWIS & CLARK ORTHOPAEDIC INSTITUTE LLC
Practice Location:
318 WARNER DR LEWISTON, ID 83501 US
Tel: 208-298-1050 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:
318 WARNER DR LEWISTON, ID 83501 US
Tel: 208-298-1050 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 261QA1903X | Ambulatory Health Care Facilities Clinic/Center Ambulatory Surgical |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
TRICARE | 3570555 | ID | 01 |
IBC | 04606 | ID | 01 |
806919700 | ID | 05 | |
OWCP | 611193000 | ID | 01 |
WWL | 7124381 | ID | 01 |
RBS | 000010146573 | ID | 01 |
WLI | 0198920 | ID | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin