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General NPI Number Information
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NPI Number | 1457345530
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Entity Type | Organization
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Legal Business Name | SYRINGA SURGICAL CENTER
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 04/19/2016
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Provider Practice Location Address
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Address Line | 1630 23RD AVE SUITE 901B
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City | LEWISTON
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State | ID
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Zip | 83501-6350
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Country | US
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Telephone | 208-298-0103
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Fax | 208-746-8566
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Provider Business Mailing Address
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Address Line | 1630 23RD AVE SUITE 901B
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City | LEWISTON
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State | ID
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Zip | 83501-6353
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Country | US
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Telephone | 208-298-0103
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Fax | 208-746-8566
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. VALERIE RAMSDEN
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Credential |
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Telephone | 208-298-0103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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