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Contact Information

EAST FALLS PLASTIC SURGERY LLC
2860 CHANNING WAY
SUITE 114A
IDAHO FALLS, ID83404-7531
 Phone: 208-535-4565
 Fax: 208-535-4564
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for EAST FALLS PLASTIC SURGERY LLC

NPI # 1023267895
LBN Legal business name EAST FALLS PLASTIC SURGERY LLC
Authorized official DAVID KANE - (VP)
Entity Organization
Organization subpart 1 No
Enumeration date 09/16/2008
Last updated 02/18/2010 - About 16 years ago
Identifiers
ID Medicaid 1023267895
ID Medicaid 808218000
MT Medicaid 1023267895
WY Medicaid 1023267895
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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