MEDICARE: PALOUSE SURGERY CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center		ID

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1870569	OTHER	ID	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750386256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALOUSE SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	2300 W A ST
Second Line	:
City	:	MOSCOW
State	:	ID
Zip	:	83843-4038
Country	:	US
Telephone Number	:	208-883-1500
Fax Number	:	208-882-7701

Provider Business Practice Location Address
First Line	:	2300 W A ST
Second Line	:
City	:	MOSCOW
State	:	ID
Zip	:	83843-4038
Country	:	US
Telephone Number	:	208-883-1500
Fax Number	:	208-882-7701

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SUSAN NEEDHAM
Credential	:
Telephone Number	:	208-883-1500

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	02/13/2024

Similar Medicare Providers

1164427423 — DR. CHRISTINA LEIGH CERVIERI MD
Practice Location Address:

2301 W A ST
MOSCOW, ID
83843-4038

Practice Phone: 208-883-1135
Practice Fax: 208-892-0174

1265425714 — ROBERT L ELLISON CRNA
Practice Location Address:

2300 W A ST
MOSCOW, ID
83843-4038

Practice Phone: 208-883-1500
Practice Fax: 208-882-7701

1255324653 — INLAND ANESTHESIA
Practice Location Address:

2300 W A ST
MOSCOW, ID
83843-4038

Practice Phone: 208-882-7530
Practice Fax:

1861486565 — ROBERT K SMITH CRNA
Practice Location Address:

2300 W A ST
MOSCOW, ID
83843-4038

Practice Phone: 208-883-1500
Practice Fax: 208-882-7701

1053397901 — LEO Y CHOUGH MD
Practice Location Address:

2301 W A ST
MOSCOW, ID
83843-4038

Practice Phone: 208-883-1135
Practice Fax:

1992878946 — JASON S PHILLIPS PA-C
Practice Location Address:

2301 W A ST
MOSCOW, ID
83843-4038

Practice Phone: 208-883-1135
Practice Fax: 208-892-0174

Directions to “PALOUSE SURGERY CENTER, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.