=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093674301
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH IDAHO DAY SURGERY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2026
-----------------------------------------------------
Last Update Date | 03/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 622 W COLLEGE AVE STE 2
-----------------------------------------------------
City | ST MARIES
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83861-1822
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-568-7800
-----------------------------------------------------
Fax | 877-902-7131
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1593 E POLSTON AVE
-----------------------------------------------------
City | POST FALLS
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83854-5326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 208-262-2300
-----------------------------------------------------
Fax | 208-262-2390
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PAYER ENROLLMENT SPECIALIST
-----------------------------------------------------
Name | JASON BELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 208-618-2559
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------