| Organization Name: | PEND OREILLE SURGERY CENTER LLC |
| NPI Number: | 1821276353 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTI SABO (EXECUTIVE DIRECTOR) |
| Mailing Address: | 30544 Highway 200 Suite 201 Ponderay |
| State: | ID US |
| Postal Code: | 838525005 |
| Phone Number: | 2082658194 |
| Fax Number: | 2082654870 |
| NPI Enumeration Date: | 02/06/2008 |
| NPI Last Update Date: | 04/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |