MADISON AVENUE SURGERY CENTER LLC – NPI #1396100491
Clinic/Center

MADISON AVENUE SURGERY CENTER LLC is an AHC clinic located in IDAHO FALLS, ID. NPPES has assigned the NPI number 1396100491 to MADISON AVENUE SURGERY CENTER LLC on December 16, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MADISON AVENUE SURGERY CENTER LLC below.

NPI Profile for
MADISON AVENUE SURGERY CENTER LLC

NPI Number
1396100491
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MADISON AVENUE SURGERY CENTER LLC
Primary location
3760 WASHINGTON PKWY
IDAHO FALLS, ID 83404-7593
Phone: (208) 881-5351 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MARK FREEMAN
PRESIDENT
Phone: (208) 881-5351
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.