LEWIS CLARK ENDOSCOPY PLLC NPI 1437148004

NPI Information

NPI: 1437148004
Provider Name: LEWIS CLARK ENDOSCOPY, PLLC
Classification: Clinic/Center - 261QE0800X
Entity Type: Organization

Specialization: Endoscopy

Address:
1630 23RD AVE
SUITE 801
LEWISTON, ID
ZIP 83501
Phone: (208) 298-3002
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LEWIS CLARK ENDOSCOPY, PLLC is an endoscopy clinic center in Lewiston, ID. LEWIS CLARK ENDOSCOPY, PLLC NPI is 1437148004. The provider is registered as an organization entity type.

The provider's business location address is:

1630 23RD AVE
SUITE 801
LEWISTON, ID
ZIP 83501-345
Phone: (208) 298-3002
Fax: (208) 743-3369

The provider's authorized official is Tamara Lynn Smith .
The authorized official title is Clinical Director and has the following contact phone number (208) 298-3002.

The enumeration date for this NPI number is 10/17/2005 and was last updated on 3/22/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0800X	Clinic/Center	Endoscopy			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	P00183405	MEDICARE PIN
2	1870606	MEDICARE PIN
3	807105900	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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