National Provider Identifier Database

SURGERY CENTER
Ambulatory Surgical


Contact Information

SURGERY CENTER
115 FALLS AVE W
TWIN FALLS, ID83301
Phone: 208-733-1662
Fax: 208-734-1023
Website:
Specialty Taxonomy Code
* Ambulatory Surgical 261QA1903X

* Indicates primary specialty

NPI Profile & details for SURGERY CENTER

NPI Number 1497745178
Legal business name
LBN
SURGERY CENTER
Authorized official DEBORAH WENSINK - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 10/25/2005
Last updated 08/10/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • ID Medicaid: 805302100
  • Other: 000010004906 REGENCE BLE SHIELD
  • ID Other: 00331 BLUE CROSS OF ID
  • ID Other: 00331 BLUE CROSS OF ID TRAD
  • ID Other: 04473 BLUE CROSS OF IDAHO PPO

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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