IDAHO ENDOSCOPY CENTER LLC – NPI #1750616249
Clinic/Center

IDAHO ENDOSCOPY CENTER LLC is an AHC clinic located in BOISE, ID. NPPES has assigned the NPI number 1750616249 to IDAHO ENDOSCOPY CENTER LLC on October 16, 2009. 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

The NPI profile was previously updated about 6 years ago on Jul 23, 2020. 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 IDAHO ENDOSCOPY CENTER LLC below.

NPI Profile for
IDAHO ENDOSCOPY CENTER LLC

NPI Number
1750616249
Enumeration Date

(more than 16 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
IDAHO ENDOSCOPY CENTER LLC
Primary location
6259 W EMERALD ST
BOISE, ID 83704-8731
Phone: (208) 489-1900 Fax: (208) 489-1929
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MARK MALLORY
MANAGER/DOCTOR
Phone: (208) 489-1900
Updated
Certification Date
Jul 23, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for IDAHO ENDOSCOPY CENTER LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMEDICARE PTANID1871902
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.