Rexburg Surgery Center Llc in Rexburg - Ambulatory Surgical
Rexburg Surgery Center Llc - NPI 1831134584
Rexburg Surgery Center Llc is a Ambulatory Surgical in Rexburg, Idaho. Rexburg Surgery Center Llc practices all healthcare services and medical treatments related to Ambulatory Surgical. The NPI Number for Rexburg Surgery Center Llc is 1831134584. The last update date is 2020-08-22.
Rexburg Surgery Center Llc's current location address is 381 East 4th North, Rexburg, Idaho. You can contact this provider via phone number 2083592300. The mailing address for Rexburg Surgery Center Llc is 381 East 4th North, Rexburg, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Rexburg Surgery Center Llc |
|---|---|
| Address | 381 East 4th North, Rexburg, Idaho |
| Phone Number | 2083592300 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | BOARD CHAI |
|---|---|
| Authorized Official Name | Hansen M Dwayne |
| Credentials | M.D. |
| Telephone Number | 2083592300 |
NPI Number Detail
| NPI Number | 1831134584 |
|---|---|
| Provider Enumeration Date | 2006-06-17 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 381 East 4th North |
|---|---|
| City | Rexburg |
| State | Idaho (ID) |
| Post Code | 83440 |
| Phone Number | 2083592300 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Surgical |
|---|---|
| Taxonomy | 261Qa1903X |
|
Definition: Provides outpatient surgical services not requiring hospitalization. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10158869 | ID | BLUE SHIELD PROVIDER NUMB | |
| 4870 | ID | BLUE CROSS PROVIDER NUMBE | |
| 80760000 | ID | -- |
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What is the unique provider identifier assigned to Rexburg Surgery Center Llc?
The Rexburg Surgery Center Llc has been issued the NPI (National Provider Identifier) 1831134584 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Rexburg Surgery Center Llc located?
The Rexburg Surgery Center Llc is located at 381 East 4Th North, Rexburg, ID 83440.
What is the Rexburg Surgery Center Llc's specialty and taxonomy code?
The Rexburg Surgery Center Llc's specialty is Ambulatory Surgical, and the corresponding taxonomy code is 261Qa1903X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1831134584 to Rexburg Surgery Center Llc?
The Centers for Medicare & Medicaid Services originally issued the 1831134584 to Rexburg Surgery Center Llc on 2006-06-17.
When was the Rexburg Surgery Center Llc's information last updated?
The Rexburg Surgery Center Llc's information was last updated on 2020-08-22.
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