GEM STATE ENDOSCOPY NPI 1821459496

NPI Information

NPI: 1821459496
Provider Name: GEM STATE ENDOSCOPY
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 13D2115708

Address:
3709 14TH STREET
LEWISTON, ID
ZIP 83501
Phone: (208) 743-4373
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GEM STATE ENDOSCOPY is an ambulatory surgical clinic center in Lewiston, ID. GEM STATE ENDOSCOPY NPI is 1821459496. The provider is registered as an organization entity type.

The provider's business location address is:

3709 14TH STREET
LEWISTON, ID
ZIP 83501
Phone: (208) 743-4373
Fax: (208) 743-3369

The provider's authorized official is Katie Blevins .
The authorized official title is Administrator and has the following contact phone number (208) 298-2135.

The CLIA number assigned to this NPI record is 13D2115708 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/10/2016 and was last updated on 8/9/2016.

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	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

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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